1 00:00:05,080 --> 00:00:08,120 I'M CATHERINE LAW WITH THE 2 00:00:08,120 --> 00:00:10,880 COMMUNICATIONS TEAM AT THE 3 00:00:10,880 --> 00:00:12,160 NATIONAL CENTER FOR 4 00:00:12,160 --> 00:00:13,480 COMPLEMENTARY AND INTEGRATIVE 5 00:00:13,480 --> 00:00:15,400 HEALTH OR NCCIH AT THE NATIONAL 6 00:00:15,400 --> 00:00:19,160 IBS TEUTS OF HEALTH. 7 00:00:19,160 --> 00:00:19,600 -- INSTITUTES OF 8 00:00:19,600 --> 00:00:20,440 HEALTH. 9 00:00:20,440 --> 00:00:23,120 ON BEHALF OF THE DIRECTOR, 10 00:00:23,120 --> 00:00:26,840 DR. HELENE LANGEVIN I'D LIKE TO 11 00:00:26,840 --> 00:00:31,240 WELCOME YOU TO OUR INTEGRATIVE 12 00:00:31,240 --> 00:00:31,920 MEDICINE RESEARCH LECTURE SERIES 13 00:00:31,920 --> 00:00:34,000 FOR A PRESENTATION BY 14 00:00:34,000 --> 00:00:35,720 DR. MICHELLE MARTIN, UNIVERSITY 15 00:00:35,720 --> 00:00:36,920 OF TENNESSEE HEALTH SCIENCE 16 00:00:36,920 --> 00:00:37,920 CENTER. 17 00:00:37,920 --> 00:00:40,640 DR. MARTIN'S TALK IS ENTITLED 18 00:00:40,640 --> 00:00:41,240 "WELL-BEING AND THE ECONOMIC 19 00:00:41,240 --> 00:00:42,760 BURDEN OF DISEASE: WHAT ARE WE 20 00:00:42,760 --> 00:00:47,640 LEARNING FROM CANCER SURVIVORS?" 21 00:00:47,640 --> 00:00:48,920 I'M NOW PLEASED TO TURN THINGS 22 00:00:48,920 --> 00:00:50,840 OVER TO DR. DAVID SHURTLEFF, 23 00:00:50,840 --> 00:00:51,760 DEPUTY DIRECTOR OF NCCIH, TO 24 00:00:51,760 --> 00:00:52,920 INTRODUCE OUR SPEAKER. 25 00:00:52,920 --> 00:00:54,800 DR. SHURTLEFF, PLEASE TAKE IT 26 00:00:54,800 --> 00:00:55,840 AWAY. 27 00:00:55,840 --> 00:00:57,920 >>WELL, THANK YOU, KATHRYN, AND 28 00:00:57,920 --> 00:00:58,240 HI, EVERYONE. 29 00:00:58,240 --> 00:00:59,880 WELCOME TO THE SECOND OF THREE 30 00:00:59,880 --> 00:01:05,160 LECTURES FOR THE SPRING 2022 31 00:01:05,160 --> 00:01:07,120 NCCIH'S INTEGRATIVE MEDICINE 32 00:01:07,120 --> 00:01:08,880 RESEARCH LECTURE SERIES. 33 00:01:08,880 --> 00:01:10,520 TODAY'S LECTURE IS ON THE THEME 34 00:01:10,520 --> 00:01:12,360 OF EMOTIONAL WELL-BEING. 35 00:01:12,360 --> 00:01:14,760 IT REFLECTS SEVERAL KEY RESEARCH 36 00:01:14,760 --> 00:01:17,560 INTERESTS OF NCCIH, INCLUDING 37 00:01:17,560 --> 00:01:18,560 ADVANCING RESEARCH ON WHOLE 38 00:01:18,560 --> 00:01:20,040 PERSON HEALTH, FOSTERING 39 00:01:20,040 --> 00:01:23,680 RESEARCH ON HEALTH PROMOTION AND 40 00:01:23,680 --> 00:01:25,760 RESTORATION, RESILIENCE AND 41 00:01:25,760 --> 00:01:26,720 DISEASE PREVENTION, AND 42 00:01:26,720 --> 00:01:28,680 INCREASING OUR UNDERSTANDING OF 43 00:01:28,680 --> 00:01:30,960 THE ROLE OF EMOTIONAL WELL-BEING 44 00:01:30,960 --> 00:01:33,840 AND HEALTH, INCLUDING WELLNESS 45 00:01:33,840 --> 00:01:39,080 AND TO SUPPORT RESILIENCE. 46 00:01:39,080 --> 00:01:41,040 TO EXPLORE THE CONCEPT FURTHER, 47 00:01:41,040 --> 00:01:43,680 IN 2018, NCCIH AND THE OFFICE OF 48 00:01:43,680 --> 00:01:44,760 BEHAVIORAL AND SOCIAL SCIENCE 49 00:01:44,760 --> 00:01:48,120 RESEARCH HERE AT THE NIH ALONG 50 00:01:48,120 --> 00:01:49,560 WITH SEVERAL OTHER INSTITUTES 51 00:01:49,560 --> 00:01:51,360 CO-SPONSORED A ROUNDTABLE ON 52 00:01:51,360 --> 00:01:52,320 ADVANCING EMOTIONAL WELL-BEING 53 00:01:52,320 --> 00:01:52,640 RESEARCH. 54 00:01:52,640 --> 00:01:54,280 THE ROUNDTABLE IS AVAILABLE ON 55 00:01:54,280 --> 00:01:56,280 THE NCCIH WEBSITE FOR THOSE WHO 56 00:01:56,280 --> 00:01:58,240 MAY BE INTERESTED IN THOSE 57 00:01:58,240 --> 00:01:58,600 PROCEEDINGS. 58 00:01:58,600 --> 00:02:02,000 SUBSEQUENT TO THAT, IN 2021, NIH 59 00:02:02,000 --> 00:02:03,720 AWARDED MIGHT HAVE NEW RESEARCH 60 00:02:03,720 --> 00:02:05,520 NETWORKS TO ALLOW INVESTIGATORS 61 00:02:05,520 --> 00:02:08,320 TO REFINE AND TEST KEY CONCEPTS 62 00:02:08,320 --> 00:02:09,520 THAT ADVANCE -- TO ADVANCE THE 63 00:02:09,520 --> 00:02:15,000 STUDY OF EMOTIONAL WELL-BEING. 64 00:02:15,000 --> 00:02:17,440 NCCIH, THE NATIONAL INSTITUTE ON 65 00:02:17,440 --> 00:02:18,600 AGING, CHILD HEALTH AND HUMAN 66 00:02:18,600 --> 00:02:20,040 DEVELOPMENT, AND THE OFFICE OF 67 00:02:20,040 --> 00:02:22,520 BEHAVIORAL AND SOCIAL SCIENCES 68 00:02:22,520 --> 00:02:23,760 RESEARCH AND SEVERAL OTHER NIH 69 00:02:23,760 --> 00:02:25,600 COMPONENTS CONTRIBUTED TO 70 00:02:25,600 --> 00:02:26,680 FUNDING, AND YOU'LL HEAR ABOUT 71 00:02:26,680 --> 00:02:27,920 ONE OF THOSE NETWORKS TODAY FROM 72 00:02:27,920 --> 00:02:29,360 OUR SPEAKER, DR. MICHELLE 73 00:02:29,360 --> 00:02:31,000 MARTIN. 74 00:02:31,000 --> 00:02:33,480 AND FOR MORE INFORMATION ON 75 00:02:33,480 --> 00:02:34,720 NCCIH'S RESEARCH PRIORITY, 76 00:02:34,720 --> 00:02:37,880 PLEASE REVIEW OUR STRATEGIC PLAN 77 00:02:37,880 --> 00:02:39,760 FOR 2021 TO 2025, WHICH IS 78 00:02:39,760 --> 00:02:43,720 AVAILABLE ON OUR WEBSITE. 79 00:02:43,720 --> 00:02:45,480 NOW I'D LIKE TO WELCOME OUR 80 00:02:45,480 --> 00:02:47,120 FEATURED SPEAKER THIS AFTERNOON, 81 00:02:47,120 --> 00:02:50,600 DR. MICHELLE MARTIN. 82 00:02:50,600 --> 00:02:52,640 PROFESSOR IN THE COLLEGE OF 83 00:02:52,640 --> 00:02:53,560 MEDICINE'S DEPARTMENT OF 84 00:02:53,560 --> 00:02:55,200 PREVENTIVE MEDICINE AT THE 85 00:02:55,200 --> 00:02:56,080 UNIVERSITY OF TENNESSEE HEALTH 86 00:02:56,080 --> 00:02:56,960 SCIENCE CENTER. 87 00:02:56,960 --> 00:02:59,160 SHE IS ALSO CO-DIRECTOR OF THE 88 00:02:59,160 --> 00:03:00,960 TENNESSEE CLINICAL AND 89 00:03:00,960 --> 00:03:02,480 TRANSLATIONAL SCIENCE INSTITUTE, 90 00:03:02,480 --> 00:03:04,320 AND FOUNDING DIRECTOR OF THE 91 00:03:04,320 --> 00:03:07,240 CENTER FOR INNOVATION AND HEALTH 92 00:03:07,240 --> 00:03:09,040 EQUITY RESEARCH, A COMMUNITY 93 00:03:09,040 --> 00:03:12,200 CANCER ALLIANCE FOR TRAN 94 00:03:12,200 --> 00:03:12,680 TRANSFORMATIVE CHANGE. 95 00:03:12,680 --> 00:03:14,160 THROUGH THE CENTER, DR. MARTIN 96 00:03:14,160 --> 00:03:16,320 AND HER TEAM WORK TO REDUCE THE 97 00:03:16,320 --> 00:03:17,240 CANCER BURDEN ACROSS THE 98 00:03:17,240 --> 00:03:18,880 CONTINUUM AND IMPROVE HEALTH 99 00:03:18,880 --> 00:03:19,960 OUTCOMES FOR PEOPLE DIAGNOSED 100 00:03:19,960 --> 00:03:21,600 WITH CANCER WHO ARE FROM RACIAL 101 00:03:21,600 --> 00:03:24,760 OR ETHNIC MINORITY POPULATIONS. 102 00:03:24,760 --> 00:03:27,200 DR. MARTIN IS ALSO A MULTIPLE 103 00:03:27,200 --> 00:03:28,360 PRINCIPAL INVESTIGATOR OF THE 104 00:03:28,360 --> 00:03:29,720 EMOTIONAL WELL-BEING AND 105 00:03:29,720 --> 00:03:30,880 ECONOMIC BURDEN RESEARCH NETWORK 106 00:03:30,880 --> 00:03:34,600 THAT I MENTIONED PREVIOUSLY. 107 00:03:34,600 --> 00:03:36,800 SHE ALSO HOLDS A PH.D. IN 108 00:03:36,800 --> 00:03:37,880 CLINICAL PSYCHOLOGY FROM THE 109 00:03:37,880 --> 00:03:39,600 UNIVERSITY OF ALABAMA BIRMINGHAM 110 00:03:39,600 --> 00:03:42,040 AND COMPLETED HER CLINICAL 111 00:03:42,040 --> 00:03:43,160 INTERNSHIP AT WEST VIRGINIA 112 00:03:43,160 --> 00:03:44,360 UNIVERSITY DURING GRADUATE 113 00:03:44,360 --> 00:03:45,840 TRAINING AND COMPLETEDGR 114 00:03:45,840 --> 00:03:46,280 UATE TRAINING AT THE 115 00:03:46,280 --> 00:03:49,600 UNIVERSITY OF ALABAMA AT 116 00:03:49,600 --> 00:03:49,880 BIRMINGHAM. 117 00:03:49,880 --> 00:03:53,320 THE NIH FUNDERS OF HER RESEARCH 118 00:03:53,320 --> 00:03:54,280 INCLUDE NCCIH, THE NATIONAL 119 00:03:54,280 --> 00:03:55,160 CANCER INSTITUTE, AND THE 120 00:03:55,160 --> 00:03:56,520 NATIONAL INSTITUTE ON MINORITY 121 00:03:56,520 --> 00:03:58,040 HEALTH AND HEALTH DISPARITIES. 122 00:03:58,040 --> 00:04:01,520 SO WITH THAT, MICHELLE, WELCOME, 123 00:04:01,520 --> 00:04:03,720 AND I TURN THE MIC OVER TO YOU. 124 00:04:03,720 --> 00:04:04,360 >> OKAY. 125 00:04:04,360 --> 00:04:06,160 THANK YOU, DR. SHURTLEFF, VERY 126 00:04:06,160 --> 00:04:07,560 MUCH FOR THAT KIND INTRODUCTION, 127 00:04:07,560 --> 00:04:08,760 AND FOR THE INVITATION TO BE 128 00:04:08,760 --> 00:04:09,800 HERE TODAY. 129 00:04:09,800 --> 00:04:14,480 IT TRULY IS AN HONOR TO BE AN 130 00:04:14,480 --> 00:04:15,600 INVITED SPEAKER FOR THIS 131 00:04:15,600 --> 00:04:17,000 IMPORTANT LECTURE SERIES. 132 00:04:17,000 --> 00:04:18,240 I'M ESPECIALLY EXCITED BECAUSE 133 00:04:18,240 --> 00:04:19,840 OF THE INSTITUTE'S FOCUS ON 134 00:04:19,840 --> 00:04:20,720 WHOLE PERSON HEALTH. 135 00:04:20,720 --> 00:04:22,800 I BELIEVE MY TALK TODAY WHICH 136 00:04:22,800 --> 00:04:24,320 WILL TALK ABOUT HEALTH IN 137 00:04:24,320 --> 00:04:25,080 MULTIPLE DOMAINS FOR CANCER 138 00:04:25,080 --> 00:04:27,280 SURVIVORS REALLY ALIGNS NICELY 139 00:04:27,280 --> 00:04:28,000 WITH THAT. 140 00:04:28,000 --> 00:04:29,120 TODAY'S PRESENTATION, I'VE 141 00:04:29,120 --> 00:04:32,040 ORGANIZED IT INTO THREE PARTS. 142 00:04:32,040 --> 00:04:33,440 I'LL BEGIN FIRST WITH A VERY 143 00:04:33,440 --> 00:04:35,760 HIGH LEVEL OVERVIEW OF CANCER 144 00:04:35,760 --> 00:04:36,520 SURVIVORSHIP IN THE UNITED 145 00:04:36,520 --> 00:04:37,600 STATES. 146 00:04:37,600 --> 00:04:39,280 AND THIS IS REALLY AN OVERVIEW 147 00:04:39,280 --> 00:04:42,040 TO PROVIDE A CONTEXT FOR THE 148 00:04:42,040 --> 00:04:45,040 PRESENTATION OVERALL. 149 00:04:45,040 --> 00:04:46,920 IN THE SECOND PART OF THE 150 00:04:46,920 --> 00:04:47,760 PRESENTATION, I'LL PRESENT TO 151 00:04:47,760 --> 00:04:49,920 YOU QUALITY OF LIFE AND DOMAINS 152 00:04:49,920 --> 00:04:51,840 OF WELL-BEING, SPECIFICALLY, 153 00:04:51,840 --> 00:04:54,000 PHYSICAL WELL-BEING AND 154 00:04:54,000 --> 00:04:56,120 SYMPTOMS, PSYCHOLOGICAL 155 00:04:56,120 --> 00:04:57,760 WELL-BEING, SOCIAL WELL-BEING, 156 00:04:57,760 --> 00:04:59,800 AND SPIRITUAL WELL-BEING. 157 00:04:59,800 --> 00:05:02,360 FOR PHYSICAL WELL-BEING AND 158 00:05:02,360 --> 00:05:03,360 SYMPTOMS, PSYCHOLOGICAL 159 00:05:03,360 --> 00:05:05,240 WELL-BEING AND SPIRITUAL 160 00:05:05,240 --> 00:05:06,040 WELL-BEING, I'LL PROVIDE YOU 161 00:05:06,040 --> 00:05:08,280 SOME EXAMPLES OF RESEARCH 162 00:05:08,280 --> 00:05:09,680 STUDIES CURRENTLY IN THE FIELD 163 00:05:09,680 --> 00:05:11,520 THAT ARE ADDRESSING THE NEEDS OF 164 00:05:11,520 --> 00:05:13,080 CANCER SURVIVORS IN THESE 165 00:05:13,080 --> 00:05:14,560 DOMAINS. 166 00:05:14,560 --> 00:05:16,680 WITH RESPECT TO SOCIAL 167 00:05:16,680 --> 00:05:18,320 WELL-BEING, I'LL GO A LITTLE BIT 168 00:05:18,320 --> 00:05:19,640 DEEPER AND THAT'S WHEN I'LL TALK 169 00:05:19,640 --> 00:05:21,160 ABOUT OUR EMOTIONAL WELL-BEING 170 00:05:21,160 --> 00:05:23,760 AND ECONOMIC BURDEN OF DISEASE 171 00:05:23,760 --> 00:05:26,280 RESEARCH NETWORK. 172 00:05:26,280 --> 00:05:27,480 I'LL CONCLUDE THE PRESENTATION 173 00:05:27,480 --> 00:05:29,680 WITH SOME REFLECTIONS THAT 174 00:05:29,680 --> 00:05:31,760 HOPEFULLY PROVIDES SOME NICE 175 00:05:31,760 --> 00:05:33,280 TALKING POINTS THAT WE COULD 176 00:05:33,280 --> 00:05:35,080 DISCUSS FURTHER IN THE QUESTION 177 00:05:35,080 --> 00:05:38,120 AND ANSWER PART OF THE 178 00:05:38,120 --> 00:05:41,280 PRESENTATION. 179 00:05:41,280 --> 00:05:42,600 SO BEGINNING WITH THE OVERVIEW 180 00:05:42,600 --> 00:05:47,000 OF CANCER SURVIVORSHIP. 181 00:05:47,000 --> 00:05:48,520 I LOVE TO BE ABLE TO SHARE GOOD 182 00:05:48,520 --> 00:05:50,280 NEWS AND WE HAVE GOOD NEWS WHEN 183 00:05:50,280 --> 00:05:51,240 WE THINK ABOUT CANCER. 184 00:05:51,240 --> 00:05:52,320 WE HAVE MADE SIGNIFICANT 185 00:05:52,320 --> 00:05:55,080 PROGRESS IN THE FIGHT AGAINST 186 00:05:55,080 --> 00:05:57,240 CANCER, DUE TO INCREASES IN 187 00:05:57,240 --> 00:06:00,400 EARLY DETECTION OF CANCER AS 188 00:06:00,400 --> 00:06:04,600 WELL AS IMPROVED TREATMENTS. 189 00:06:04,600 --> 00:06:06,120 AS SUCH, WE HAVE A NUMBER OF 190 00:06:06,120 --> 00:06:08,200 CANCER SURVIVORS LIVING WITH US 191 00:06:08,200 --> 00:06:09,000 TODAY. 192 00:06:09,000 --> 00:06:11,120 THE FIRST PART OF THIS SLIDE 193 00:06:11,120 --> 00:06:13,560 SHOWS AS OF JANUARY 1ST, 2019, 194 00:06:13,560 --> 00:06:16,880 WE HAD ABOUT 16.9 MILLION 195 00:06:16,880 --> 00:06:18,720 INDIVIDUALS LIVING IN THE U.S. 196 00:06:18,720 --> 00:06:20,800 WHO ARE CANCER SURVIVORS. 197 00:06:20,800 --> 00:06:23,480 IT IS EXPECTED BY JANUARY 1ST OF 198 00:06:23,480 --> 00:06:26,560 2030 THAT THAT NUMBER WILL 199 00:06:26,560 --> 00:06:28,640 EXCEED 21 MILLION. 200 00:06:28,640 --> 00:06:30,840 CANCER SURVIVORS LIVING WITH US. 201 00:06:30,840 --> 00:06:35,120 THIS NEXT SLIDE I THINK EVEN 202 00:06:35,120 --> 00:06:37,560 ILLUSTRATES IT BETTER, AS YOU 203 00:06:37,560 --> 00:06:39,600 CAN SEE THE INCREASE OF CANCER 204 00:06:39,600 --> 00:06:41,720 SURVIVORS FROM 1970 KNIFE 205 00:06:41,720 --> 00:06:43,440 ESTIMATED TO THE YEAR 2040. 206 00:06:43,440 --> 00:06:46,760 THE YEAR 2040, WE EXPECT THAT 207 00:06:46,760 --> 00:06:47,680 26.1 MILLION AMERICANS WILL BE 208 00:06:47,680 --> 00:06:50,120 CANCER SURVIVORS, THE MAJORITY 209 00:06:50,120 --> 00:06:54,200 OF THOSE BEING IN THE OLDER 210 00:06:54,200 --> 00:06:56,760 POPULATION. 211 00:06:56,760 --> 00:06:58,440 THIS IS WONDERFUL NEWS THAT WE 212 00:06:58,440 --> 00:07:00,120 HAVE MANY CANCER SURVIVORS. 213 00:07:00,120 --> 00:07:01,520 AS YOU THINK ABOUT TREATING 214 00:07:01,520 --> 00:07:02,680 DISEASE, HOWEVER, WE ALSO KNOW 215 00:07:02,680 --> 00:07:04,200 IT'S IMPORTANT TO THINK ABOUT 216 00:07:04,200 --> 00:07:06,640 THE WHOLE PATIENT. 217 00:07:06,640 --> 00:07:08,600 AS SUCH, A FEW YEARS AGO, THE 218 00:07:08,600 --> 00:07:11,120 INSTITUTE OF MEDICINE HAD A 219 00:07:11,120 --> 00:07:12,120 PUBLICATION TITLED "CANCER CARE 220 00:07:12,120 --> 00:07:14,440 FOR THE WHOLE PATIENT." 221 00:07:14,440 --> 00:07:16,280 WITH A REAL CALL FOR US TO FOCUS 222 00:07:16,280 --> 00:07:17,840 ON PSYCHOSOCIAL HEALTH. 223 00:07:17,840 --> 00:07:20,680 AND THEY DEFINE PSYCHOSOCIAL 224 00:07:20,680 --> 00:07:22,200 HEALTH AS SERVICES THAT ARE 225 00:07:22,200 --> 00:07:23,600 PSYCHOLOGICAL AND SOCIAL 226 00:07:23,600 --> 00:07:25,880 SERVICES AND INTERVENTIONS THAT 227 00:07:25,880 --> 00:07:28,320 ENABLE PATIENTS, THEIR FAMILIES, 228 00:07:28,320 --> 00:07:30,640 AND HEALTHCARE PROVIDERS TO 229 00:07:30,640 --> 00:07:31,880 OPTIMIZE BIOMEDICAL HEALTHCARE 230 00:07:31,880 --> 00:07:35,880 AND TO MANAGE THE 231 00:07:35,880 --> 00:07:36,480 PSYCHOLOGICAL/BEHAVIORAL AND 232 00:07:36,480 --> 00:07:38,840 SOCIAL ASPECTS OF ILLNESS AND 233 00:07:38,840 --> 00:07:40,280 ITS CONSEQUENCES SO AS TO 234 00:07:40,280 --> 00:07:45,640 PROMOTE BETTER HEALTH. 235 00:07:45,640 --> 00:07:46,720 AND THIS IS WHERE I BELIEVE 236 00:07:46,720 --> 00:07:48,360 QUALITY OF LIFE AND WELL-BEING 237 00:07:48,360 --> 00:07:51,240 REALLY PLAYS A ROLE. 238 00:07:51,240 --> 00:07:53,720 IN THIS NEXT SLIDE, I'M 239 00:07:53,720 --> 00:08:00,400 PRESENTING TO YOU A MODEL USED 240 00:08:00,400 --> 00:08:01,400 BY PERMISSION FROM THE CITY OF 241 00:08:01,400 --> 00:08:01,720 HOPE. 242 00:08:01,720 --> 00:08:03,160 AS YOU CAN SEE FROM THIS MODEL, 243 00:08:03,160 --> 00:08:04,360 WHEN WE THINK ABOUT WHOLE 244 00:08:04,360 --> 00:08:07,320 HEALTH, WHEN WE THINK ABOUT 245 00:08:07,320 --> 00:08:08,880 QUALITY OF LIFE OF CANCER 246 00:08:08,880 --> 00:08:10,360 SURVIVOR, WE THINK ABOUT FOUR 247 00:08:10,360 --> 00:08:10,600 DOMAINS. 248 00:08:10,600 --> 00:08:12,120 WE HAVE THE PHYSICAL WELL-BEING 249 00:08:12,120 --> 00:08:13,440 AND SYMPTOMS DOMAIN THAT 250 00:08:13,440 --> 00:08:14,560 INCLUDES ACTIVITIES SUCH AS 251 00:08:14,560 --> 00:08:17,720 FUNCTIONAL ACTIVITIES, ONE'S 252 00:08:17,720 --> 00:08:19,240 STRENGTH, ONE'S FATIGUE, SLEEP 253 00:08:19,240 --> 00:08:23,480 AND REST, ONE'S OVERALL PHYSICAL 254 00:08:23,480 --> 00:08:25,040 HEALTH, FERTILITY, AND PAIN. 255 00:08:25,040 --> 00:08:27,240 WHEN WE CONSIDER PSYCHOLOGICAL 256 00:08:27,240 --> 00:08:28,600 WELL-BEING, THE SECOND DOMAIN, 257 00:08:28,600 --> 00:08:30,880 WE THINK ABOUT INDIVIDUALS' 258 00:08:30,880 --> 00:08:32,400 PERCEPTION OF THEIR CONTROL OF 259 00:08:32,400 --> 00:08:35,560 THEIR SITUATION, ANXIETY, 260 00:08:35,560 --> 00:08:37,680 DEPRESSION, ENJOYMENT/LEISURE 261 00:08:37,680 --> 00:08:39,720 ACTIVITIES, FEAR OF RECURRENCE, 262 00:08:39,720 --> 00:08:44,040 THEIR COGNITION AND ATTENTION, 263 00:08:44,040 --> 00:08:45,400 INDIVIDUALS MAY -- INDIVIDUALS 264 00:08:45,400 --> 00:08:46,640 WITH CANCER TALK ABOUT HAVING 265 00:08:46,640 --> 00:08:47,960 CHEMO BRAIN, THAT THEY JUST 266 00:08:47,960 --> 00:08:49,240 DON'T THINK AS WELL, LIKE THEY 267 00:08:49,240 --> 00:08:53,400 USED TO. 268 00:08:53,400 --> 00:08:55,040 DISTRESS OF DIAGNOSIS AND 269 00:08:55,040 --> 00:08:56,160 CONTROL OF TREATMENT. 270 00:08:56,160 --> 00:08:57,360 WHEN WE CONSIDER SOCIAL 271 00:08:57,360 --> 00:08:58,640 WELL-BEING, WE CONSIDER FAMILY 272 00:08:58,640 --> 00:09:00,880 DISTRESS, ROLES AND 273 00:09:00,880 --> 00:09:02,360 RELATIONSHIPS, AFFECTION/SEXUAL 274 00:09:02,360 --> 00:09:03,160 FUNCTION, APPEARANCE, ENJOYMENT 275 00:09:03,160 --> 00:09:05,680 AGAIN ALSO FITS HERE, ISOLATION, 276 00:09:05,680 --> 00:09:07,240 FINANCES, AND WORK. 277 00:09:07,240 --> 00:09:09,320 AND FINALLY, THE FOURTH DOMAIN, 278 00:09:09,320 --> 00:09:11,280 SPIRITUAL WELL-BEING. 279 00:09:11,280 --> 00:09:16,320 MEANING OF ILLNESS, RELIGIOSITY, 280 00:09:16,320 --> 00:09:17,360 TRAN 16 DENSE, HOPE, 281 00:09:17,360 --> 00:09:20,120 UNCERTAINTY, AND INNER STRENGTH. 282 00:09:20,120 --> 00:09:22,200 WHILE IT'S IMPORTANT TO 283 00:09:22,200 --> 00:09:23,080 CONCEPTUALIZE WELL-BEING, I 284 00:09:23,080 --> 00:09:25,160 THINK IT'S ALSO IMPORTANT TO 285 00:09:25,160 --> 00:09:26,800 HEAR FROM CANCER SURVIVORS, SO I 286 00:09:26,800 --> 00:09:28,640 HAVE A SHORT VIDEO FOR YOU NOW 287 00:09:28,640 --> 00:09:39,200 SO YOU CAN HEAR SOMEONE'S STORY. 288 00:09:39,200 --> 00:09:41,320 >> EVERY DAY THE SUN IS SHINING 289 00:09:41,320 --> 00:09:43,800 ON YOU, WHEN IT'S NOT, EVEN WHEN 290 00:09:43,800 --> 00:09:45,200 IT SHOULD BE. 291 00:09:45,200 --> 00:09:47,600 THERE'S A LOT OF SCARS ON THE 292 00:09:47,600 --> 00:09:49,040 INSIDE THAT PEOPLE DON'T KNOW 293 00:09:49,040 --> 00:09:51,880 AND DON'T SEE. 294 00:09:51,880 --> 00:09:59,040 AND THEY DON'T UNDERSTAND. 295 00:09:59,040 --> 00:10:02,880 A FEW MONTHS AFTER MY FINAL 296 00:10:02,880 --> 00:10:04,200 REMISSION, I'D GO TO THE GYM AND 297 00:10:04,200 --> 00:10:06,280 STRUGGLE WITH JUST THE BAR. 298 00:10:06,280 --> 00:10:07,360 I WOULD JUST STRUGGLE WITH 299 00:10:07,360 --> 00:10:08,760 TRYING TO WALK ON A TREADMILL 300 00:10:08,760 --> 00:10:11,280 FOR MORE THAN TWO MINUTES. 301 00:10:11,280 --> 00:10:13,160 YOU WANT THE IMMEDIATE 302 00:10:13,160 --> 00:10:14,120 SATISFACTION OF PROGRESS. 303 00:10:14,120 --> 00:10:16,120 YOU WANT TO SEE IT RIGHT AWAY. 304 00:10:16,120 --> 00:10:18,760 AND YOU DON'T. 305 00:10:18,760 --> 00:10:20,800 I HAD SO MUCH TO REBUILD JUST 306 00:10:20,800 --> 00:10:22,560 PHYSICALLY, AND EMOTIONALLY 307 00:10:22,560 --> 00:10:23,360 OBVIOUSLY FROM THE DISTANCE I 308 00:10:23,360 --> 00:10:25,200 WAS PUTTING MYSELF FROM PEOPLE, 309 00:10:25,200 --> 00:10:26,720 I JUST WANTED TO CRAWL IN BED 310 00:10:26,720 --> 00:10:29,120 AND STAY THERE AND NOT GET BACK 311 00:10:29,120 --> 00:10:29,360 UP. 312 00:10:29,360 --> 00:10:30,880 BUT YOU HAVE TO TAKE THOSE BABY 313 00:10:30,880 --> 00:10:33,640 STEPS TO GET OUT AND MAKE IT 314 00:10:33,640 --> 00:10:35,200 BETTER, MAKE THE DAY COUNT IN 315 00:10:35,200 --> 00:10:37,120 ONE WAY, EVEN IF IT'S JUST THE 316 00:10:37,120 --> 00:10:38,760 LITTLEST THINGS LIKE FOLDING 317 00:10:38,760 --> 00:10:39,720 YOUR LAUNDRY. 318 00:10:39,720 --> 00:10:41,480 LIKE, THAT CAN JUST BE THE WIN 319 00:10:41,480 --> 00:10:42,680 FOR THE DAY. 320 00:10:42,680 --> 00:10:47,720 AND HOPE YOU GET TO THE NEXT. 321 00:10:47,720 --> 00:10:50,480 THE MOST IMPACTFUL MOMENT I 322 00:10:50,480 --> 00:10:52,640 PROBABLY HAD POST-CANCER TO HELP 323 00:10:52,640 --> 00:10:55,520 ME EMOTIONALLY GET BETTER IS 324 00:10:55,520 --> 00:10:59,440 JUST ALLOW MYSELF TO SEE MY 325 00:10:59,440 --> 00:11:01,000 FAULTS, AND TO SEE THAT I DO 326 00:11:01,000 --> 00:11:03,960 NEED HELP. 327 00:11:03,960 --> 00:11:04,960 I WOULDN'T HAVE COME THIS FAR 328 00:11:04,960 --> 00:11:06,160 WITHOUT A GREAT GROUP OF PEOPLE 329 00:11:06,160 --> 00:11:06,720 AROUND ME. 330 00:11:06,720 --> 00:11:10,760 NO MATTER HOW HARD I TRY TO PUSH 331 00:11:10,760 --> 00:11:13,560 THEM AWAY, THEY WOULDN'T GO 332 00:11:13,560 --> 00:11:13,760 AWAY. 333 00:11:13,760 --> 00:11:15,480 SO JUST THE PEOPLE WHO ARE 334 00:11:15,480 --> 00:11:17,000 AROUND YOU, NO ONE ELSE HAD 335 00:11:17,000 --> 00:11:18,080 CANCER, NO ONE ELSE GOES THROUGH 336 00:11:18,080 --> 00:11:19,640 IT, BUT THEY ALL GO THROUGH IT. 337 00:11:19,640 --> 00:11:22,320 AND YOU'RE NEVER ALONE IN 338 00:11:22,320 --> 00:11:24,320 TREATMENT, YOU'RE DEFINITELY NOT 339 00:11:24,320 --> 00:11:25,320 ALONE AFTER. 340 00:11:25,320 --> 00:11:26,880 WE NEED THE MOST HELP MAYBE, 341 00:11:26,880 --> 00:11:30,680 THEY'RE ALWAYS THERE. 342 00:11:30,680 --> 00:11:32,440 SOME ADVICE I WOULD GIVE A 343 00:11:32,440 --> 00:11:34,200 SURVIVOR, GIVE YOURSELF 344 00:11:34,200 --> 00:11:34,520 LENIENCY. 345 00:11:34,520 --> 00:11:36,240 YOU HAVE TO GIVE YOURSELF THAT 346 00:11:36,240 --> 00:11:46,760 ROOM TO GROW INTO THE NEW YOU. 347 00:11:47,760 --> 00:11:50,080 >> IN THAT SHORT, SHORT 2-MINUTE 348 00:11:50,080 --> 00:11:51,600 VIDEO, AND WE THANK MARK FOR 349 00:11:51,600 --> 00:11:52,800 SHARING HIS STORY, YOU CAN SEE 350 00:11:52,800 --> 00:11:54,800 HOW CANCER HAS AFFECTED MULTIPLE 351 00:11:54,800 --> 00:11:56,960 QUALITY OF LIFE DOMAINS THAT ARE 352 00:11:56,960 --> 00:11:58,480 CONSISTENT WITH THE CONCEPTUAL 353 00:11:58,480 --> 00:11:59,600 MODEL THAT I HAD JUST SHARED 354 00:11:59,600 --> 00:12:00,920 WITH YOU. 355 00:12:00,920 --> 00:12:02,760 THE INNER SCARS, WHETHER THAT BE 356 00:12:02,760 --> 00:12:05,160 ANXIETY, DEPRESSION, FEAR OF 357 00:12:05,160 --> 00:12:07,560 RECURRENCE, THE SOCIAL ASPECT, 358 00:12:07,560 --> 00:12:09,200 THE LIMITATIONS FUNCTIONALLY, 359 00:12:09,200 --> 00:12:10,080 BEING UNABLE TO GO TO THE GYM 360 00:12:10,080 --> 00:12:12,280 AND BE ON THE TREADMILL FOR VERY 361 00:12:12,280 --> 00:12:13,560 LONG. 362 00:12:13,560 --> 00:12:14,920 AND THEN FINDING NEW MEANING, 363 00:12:14,920 --> 00:12:17,120 FINDING MEANING IN BEING ABLE TO 364 00:12:17,120 --> 00:12:18,840 FOALT 365 00:12:18,840 --> 00:12:20,400 BOLD THAT 366 00:12:20,400 --> 00:12:22,880 FOLD THE LAUNDRY, SEEING THAT AS 367 00:12:22,880 --> 00:12:24,720 A WIN AND GETTING THAT DONE, SO 368 00:12:24,720 --> 00:12:25,720 CANCER DEFINITELY HAS MULTIPLE 369 00:12:25,720 --> 00:12:27,160 AREAS OF WELL-BEING THAT WE MUST 370 00:12:27,160 --> 00:12:27,520 ALWAYS CONSIDER. 371 00:12:27,520 --> 00:12:29,040 IN DOING SO, AS I PROMISED, I 372 00:12:29,040 --> 00:12:31,120 WILL SHARE WITH YOU SOME CURRENT 373 00:12:31,120 --> 00:12:32,520 RESEARCH STUDIES THAT ARE IN THE 374 00:12:32,520 --> 00:12:33,960 FIELD THAT ARE ADDRESSING THE 375 00:12:33,960 --> 00:12:36,040 NEEDS OF CANCER SURVIVORS. 376 00:12:36,040 --> 00:12:38,320 AND THEN I WILL CONCLUDE BY 377 00:12:38,320 --> 00:12:38,840 TALKING SPECIFICALLY ABOUT 378 00:12:38,840 --> 00:12:40,840 SOCIAL WELL-BEING AND OUR 379 00:12:40,840 --> 00:12:46,880 NETWORK. 380 00:12:46,880 --> 00:12:50,240 THIS FIRST STUDY IS LED AT THE 381 00:12:50,240 --> 00:12:52,480 UNIVERSITY OF ALABAMA AT 382 00:12:52,480 --> 00:12:52,800 BIRMINGHAM. 383 00:12:52,800 --> 00:12:54,320 I'M ALSO A PART OF THIS STUDY AS 384 00:12:54,320 --> 00:12:56,880 AB INVESTIGATOR AND LEADING SOME 385 00:12:56,880 --> 00:12:58,360 OF THE RECRUITMENT AND RETENTION 386 00:12:58,360 --> 00:12:58,680 ACTIVITIES. 387 00:12:58,680 --> 00:12:59,920 THE NAME OF THE STUDY IS 388 00:12:59,920 --> 00:13:01,240 ADAPTING MULTIPLE BEHAVIOR 389 00:13:01,240 --> 00:13:02,440 INTERVENTIONS THAT EFFECTIVELY 390 00:13:02,440 --> 00:13:05,080 IMPROVE CANCER SURVIVOR HEALTH. 391 00:13:05,080 --> 00:13:08,520 ALSO KNOWN AS AMPLIFI. 392 00:13:08,520 --> 00:13:11,400 SO WHAT IS AMPLIFI? 393 00:13:11,400 --> 00:13:13,560 IT SEEKS TO TEST THE EFFECTS OF 394 00:13:13,560 --> 00:13:15,240 THREE WEB-BASED DIET AND 395 00:13:15,240 --> 00:13:16,800 EXERCISE INTERVENTIONS ON 396 00:13:16,800 --> 00:13:20,480 BEHAVIOR CHANGE AND HEALTH 397 00:13:20,480 --> 00:13:23,640 OUTCOMES. 398 00:13:23,640 --> 00:13:25,840 ONE ARM WILL INVOLVE SIX MONTHS 399 00:13:25,840 --> 00:13:27,960 OF DIET/WEIGHT-LOSS PROGRAM 400 00:13:27,960 --> 00:13:30,680 FOLLOWED BY SIX-MONTH EXERCISE 401 00:13:30,680 --> 00:13:31,880 PROGRAM. 402 00:13:31,880 --> 00:13:32,760 THE SECOND ARM WILL BE SIX 403 00:13:32,760 --> 00:13:34,400 MONTHS OF EXERCISE PROGRAM 404 00:13:34,400 --> 00:13:36,480 FOLLOWED BY SIX-MONTH DIET AND 405 00:13:36,480 --> 00:13:38,240 WEIGHT-LOSS PROGRAM. 406 00:13:38,240 --> 00:13:39,720 THE THIRD ARM WILL BE 12 MONTHS 407 00:13:39,720 --> 00:13:41,440 COMBINED, A PROGRAM OF BOTH DIET 408 00:13:41,440 --> 00:13:43,040 AND WEIGHT LOSS AND EXERCISE AT 409 00:13:43,040 --> 00:13:47,440 THE SAME TIME. 410 00:13:47,440 --> 00:13:49,320 SO WHY IS THIS STUDY IMPORTANT? 411 00:13:49,320 --> 00:13:51,720 WE KNOW THAT EXCESS BODY WEIGHT 412 00:13:51,720 --> 00:13:53,800 IS ASSOCIATED WITH HIGHER RISK 413 00:13:53,800 --> 00:13:56,080 FOR RECURRENCE, CO-MORBIDITY, 414 00:13:56,080 --> 00:13:57,440 CANCER RELATED MORTALITY AND ALL 415 00:13:57,440 --> 00:13:58,840 CAUSE MORTALITY. 416 00:13:58,840 --> 00:14:00,160 WE ALSO KNOW THAT EXERCISE 417 00:14:00,160 --> 00:14:01,640 DECREASES THE RISK OF SECOND 418 00:14:01,640 --> 00:14:03,560 PRIMARY CANCERS, CO-MORBID IT, 419 00:14:03,560 --> 00:14:05,080 REDUCE MORTALITY RISK AFTER A 420 00:14:05,080 --> 00:14:06,880 CANCER DIAGNOSIS, AND DISTRESS 421 00:14:06,880 --> 00:14:08,840 CAUSED BY POOR QUALITY OF LIFE, 422 00:14:08,840 --> 00:14:09,720 FATIGUE, ANXIETY, AND 423 00:14:09,720 --> 00:14:13,640 DEPRESSION. 424 00:14:13,640 --> 00:14:14,880 THE STUDY IS ALSO IMPORTANT 425 00:14:14,880 --> 00:14:17,960 BECAUSE WE KNOW THAT 52 TO EIGH% 426 00:14:17,960 --> 00:14:20,120 OF CANCER SURVIVORS HAVE POOR 427 00:14:20,120 --> 00:14:21,880 DIET QUALITY AND AN ESTIMATED 428 00:14:21,880 --> 00:14:24,040 71% ARE OVERWEIGHT OR OBESE, AND 429 00:14:24,040 --> 00:14:27,880 MANY CANCER SURVIVORS ARE 430 00:14:27,880 --> 00:14:28,200 UNDERACTIVE. 431 00:14:28,200 --> 00:14:30,520 SO THIS STUDY IS ENROLLING 432 00:14:30,520 --> 00:14:32,160 INDIVIDUALS AGE 50-PLUS. 433 00:14:32,160 --> 00:14:34,200 SO IF YOU ARE A CANCER SURVIVOR 434 00:14:34,200 --> 00:14:38,960 OR KNOW OF ONE AND ARE 435 00:14:38,960 --> 00:14:40,280 INTERESTED IN LOSING WEIGHT, WE 436 00:14:40,280 --> 00:14:41,560 REALLY DO ENCOURAGE YOU TO REACH 437 00:14:41,560 --> 00:14:51,160 OUT TO US. 438 00:14:51,160 --> 00:14:54,440 SO THIS IS ADDRESSING THE 439 00:14:54,440 --> 00:14:56,400 PHYSICAL DOMAIN OF QUALITY OF 440 00:14:56,400 --> 00:14:56,840 LIFE. 441 00:14:56,840 --> 00:14:59,040 THE NEXT STUDY THAT'S AN ONGOING 442 00:14:59,040 --> 00:15:02,440 TRIAL IS ABOUT DR. SHELLEY JOHNS 443 00:15:02,440 --> 00:15:03,360 AT INDIANA UNIVERSITY SCHOOL OF 444 00:15:03,360 --> 00:15:07,360 MEDICINE, AND THAT IS TITLED 445 00:15:07,360 --> 00:15:09,320 FACILITATING ADAPTIVE COPING 446 00:15:09,320 --> 00:15:11,280 WITH FEAR OF RECURRENCE AMONG 447 00:15:11,280 --> 00:15:13,560 BREAST CANCER SURVIVORS: A 448 00:15:13,560 --> 00:15:14,520 THREE-ARM RANDOMIZED CONTROLLED 449 00:15:14,520 --> 00:15:14,720 TRIAL. 450 00:15:14,720 --> 00:15:16,200 SO WHAT DO WE KNOW? 451 00:15:16,200 --> 00:15:17,400 WE KNOW FEAR OF CANCER 452 00:15:17,400 --> 00:15:19,160 RECURRENCE, WHICH IS FEAR, WORRY 453 00:15:19,160 --> 00:15:21,280 OR CONCERN, RELATING TO THE 454 00:15:21,280 --> 00:15:22,240 POSSIBILITY THAT CANCER WILL 455 00:15:22,240 --> 00:15:25,640 COME BACK OR PROGRESS, IS 456 00:15:25,640 --> 00:15:28,000 PREVALENT. 457 00:15:28,000 --> 00:15:31,160 IT'S A MILD AND TRANSIENT FORM 458 00:15:31,160 --> 00:15:33,200 FEAR OF CANCER RECURRENCE IS 459 00:15:33,200 --> 00:15:34,640 ALMOST UNIVERSAL, AND 40 TO 70% 460 00:15:34,640 --> 00:15:36,480 OF SURVIVORS REPORT CLINICALLY 461 00:15:36,480 --> 00:15:37,480 SIGNIFICANT FEAR OF CANCER 462 00:15:37,480 --> 00:15:37,800 RECURRENCE. 463 00:15:37,800 --> 00:15:41,120 WE ALSO KNOW IT'S DISRUPTIVE. 464 00:15:41,120 --> 00:15:43,000 THERE ARE EXTENSIVE EVIDENCE 465 00:15:43,000 --> 00:15:45,880 LINKS TO CLINICAL PROBLEMS 466 00:15:45,880 --> 00:15:49,120 INCLUDING ANXIETY, DEPRESSION, 467 00:15:49,120 --> 00:15:51,120 SLEEP DISTURBANCE, IMPAIRMENTS 468 00:15:51,120 --> 00:15:52,240 IN FUNCTION AND REDUCED QUALITY 469 00:15:52,240 --> 00:15:52,920 OF LIFE. 470 00:15:52,920 --> 00:15:53,800 IT'S ALSO SIGNIFICANT BECAUSE 471 00:15:53,800 --> 00:15:55,000 IT'S STABLE OVER TIME, EVEN WHEN 472 00:15:55,000 --> 00:15:58,080 THE RISK OF RECURRENCE IS FELT. 473 00:15:58,080 --> 00:15:59,280 FINALLY, FEAR OF CANCER 474 00:15:59,280 --> 00:16:01,240 RECURRENCE IS THE MOST FREEPT 475 00:16:01,240 --> 00:16:03,560 FREECTLY ENDORSED UNMET 476 00:16:03,560 --> 00:16:07,040 SUPPORTIVE CARE NEED AMONG 477 00:16:07,040 --> 00:16:07,480 SURVIVORS. 478 00:16:07,480 --> 00:16:09,120 SO IF YOU ARE A SURVIVOR OF 479 00:16:09,120 --> 00:16:11,200 BREAST CANCER AND LIVING IN 480 00:16:11,200 --> 00:16:12,720 INDIANA, DR. JOHNS IS TESTING 481 00:16:12,720 --> 00:16:15,360 THREE DIFFERENT APPROACHES TO 482 00:16:15,360 --> 00:16:17,320 ADDRESSING FEAR OF RECURRENCE, 483 00:16:17,320 --> 00:16:18,680 AND I DO ENCOURAGE YOU TO REACH 484 00:16:18,680 --> 00:16:26,920 OUT TO HER AND HER TEAM. 485 00:16:26,920 --> 00:16:29,160 THE FINAL STUDY, ONGOING STUDY 486 00:16:29,160 --> 00:16:36,000 THAT I'LL SHARE WITH YOU IS AT 487 00:16:36,000 --> 00:16:37,440 THE MEMORIAL SLOAN KETTERING 488 00:16:37,440 --> 00:16:37,880 CANCER CENTER. 489 00:16:37,880 --> 00:16:43,840 IT IS A PRAGMATIC RANDOMIZED 490 00:16:43,840 --> 00:16:47,840 CONTROL TRIAL FOR HOMEBOUND 491 00:16:47,840 --> 00:16:48,960 PALLIATIVE CARE PATIENTS. 492 00:16:48,960 --> 00:16:52,000 WE KNOW PATIENTS WITH ADVANCED 493 00:16:52,000 --> 00:16:55,720 CANCER ARE OFTEN CONFRONTED WITH 494 00:16:55,720 --> 00:16:56,600 EXISTENTIAL DISTRESS THAT 495 00:16:56,600 --> 00:16:57,760 CREATES ANXIETY AND DEPRESSION 496 00:16:57,760 --> 00:17:00,320 AND WHEN UNADDRESSED LEADS TO 497 00:17:00,320 --> 00:17:01,400 INCREASED SUFFERING AND DESPAIR. 498 00:17:01,400 --> 00:17:04,800 WE ALSO KNOW THAT HOMEBOUND 499 00:17:04,800 --> 00:17:06,440 INDIVIDUALS FACE COMPOUNDED 500 00:17:06,440 --> 00:17:07,640 EX-IS TENSION CONCERNS AND LOSS 501 00:17:07,640 --> 00:17:09,800 OF MEANING ABOVE AND BEYOND 502 00:17:09,800 --> 00:17:10,720 AMBULATORY PATIENTS WITH 503 00:17:10,720 --> 00:17:12,560 ADVANCED ILLNESSES, AS THEY MUST 504 00:17:12,560 --> 00:17:13,640 CONTEND WITH AN EVEN GREATER 505 00:17:13,640 --> 00:17:15,080 LOSS OF INDEPENDENCE AND 506 00:17:15,080 --> 00:17:15,960 DECLINING OPPORTUNITIES FOR 507 00:17:15,960 --> 00:17:17,880 ACTIVITIES AND SOCIAL 508 00:17:17,880 --> 00:17:18,200 ENGAGEMENT. 509 00:17:18,200 --> 00:17:19,880 AS THE DEMAND FOR DELIVERY OF 510 00:17:19,880 --> 00:17:21,120 COMPREHENSIVE, HIGH QUALITY 511 00:17:21,120 --> 00:17:22,280 PALLIATIVE CARE IN THE COMMUNITY 512 00:17:22,280 --> 00:17:24,680 CONTINUES TO GROW, SO DOES THE 513 00:17:24,680 --> 00:17:26,160 NEED TO ADDRESS THESE 514 00:17:26,160 --> 00:17:28,120 UNDERSERVED PATIENTS. 515 00:17:28,120 --> 00:17:29,320 MEANING CENTERED PSYCHOTHERAPY 516 00:17:29,320 --> 00:17:33,120 IS AN EMPIRICALLY SUPPORTED 517 00:17:33,120 --> 00:17:33,720 PSYCHOTHERAPEUTIC INTERVENTION 518 00:17:33,720 --> 00:17:35,640 WITH CLINICALLY SIGNIFICANT 519 00:17:35,640 --> 00:17:36,840 EFFICACY TO IMPROVING QUALITY OF 520 00:17:36,840 --> 00:17:39,680 LIFE AND ALLEVIATING LOSS OF 521 00:17:39,680 --> 00:17:42,200 MEANING, SPIRITUAL SUFFERING AND 522 00:17:42,200 --> 00:17:42,640 DESPAIR. 523 00:17:42,640 --> 00:17:44,280 SO THESE RESEARCHERS ARE SEEKING 524 00:17:44,280 --> 00:17:46,720 TO EVALUATE THE ABILITY OF A 525 00:17:46,720 --> 00:17:50,520 HOME CARE NURSE'S INTERVENTION 526 00:17:50,520 --> 00:17:52,600 TO DELIVER THIS THERAPY TO 527 00:17:52,600 --> 00:17:53,880 HOMEBOUND PATIENTS WITH ADVANCED 528 00:17:53,880 --> 00:17:54,560 CANCER DIAGNOSIS. 529 00:17:54,560 --> 00:17:57,000 IT'S A PARTNERSHIP WITH ACADEMIC 530 00:17:57,000 --> 00:17:58,840 MEDICAL CENTER AND LARGE 531 00:17:58,840 --> 00:18:00,840 COMMUNITY HOME BASED NETWORK IN 532 00:18:00,840 --> 00:18:01,080 NEW YORK. 533 00:18:01,080 --> 00:18:08,800 PRIMARY OUTCOMES WILL INCLUDE 534 00:18:08,800 --> 00:18:10,320 FEASIBILITY, ACCEPTABILITY AND 535 00:18:10,320 --> 00:18:13,080 PRELIMINARY EFFICACY OF NURSE 536 00:18:13,080 --> 00:18:14,560 DELIVERED MCP TO THOSE THAT 537 00:18:14,560 --> 00:18:16,160 WOULD OTHERWISE NOT HAVE ACCESS. 538 00:18:16,160 --> 00:18:17,240 SO INDIVIDUALS WHO MAY QUALIFY 539 00:18:17,240 --> 00:18:18,800 FOR THE STUDY, WE DO ENCOURAGE 540 00:18:18,800 --> 00:18:20,520 YOU TO REACH OUT TO THE 541 00:18:20,520 --> 00:18:24,600 PRINCIPAL INVESTIGATORS. 542 00:18:24,600 --> 00:18:25,240 HERE IN THE NEW YORK AREA. 543 00:18:25,240 --> 00:18:27,040 SO SO FAR, I'VE SHOWED YOU THE 544 00:18:27,040 --> 00:18:28,880 QUALITY OF LIFE MODEL APPLIED TO 545 00:18:28,880 --> 00:18:30,520 CANCER SURVIVORS, I'VE SHARED 546 00:18:30,520 --> 00:18:34,480 WITH YOU THE AMPLIFI STUDY 547 00:18:34,480 --> 00:18:36,160 THAT'S ADDRESSING PHYSICAL 548 00:18:36,160 --> 00:18:40,000 WELL-BEING AND SYMPTOMS, THE 549 00:18:40,000 --> 00:18:40,960 STUDY ADDRESSING SPECIFICALLY 550 00:18:40,960 --> 00:18:42,440 FEAR OF RECURRENCE AND THE 551 00:18:42,440 --> 00:18:43,880 NURSE-DELIVERED STUDY THAT'S 552 00:18:43,880 --> 00:18:46,080 ADDRESSING SPIRITUAL WELL-BEING. 553 00:18:46,080 --> 00:18:50,280 I WILL NOW TURN MY FOCUS TO 554 00:18:50,280 --> 00:18:51,520 EMOT-ECON, AND THE REMAINDER OF 555 00:18:51,520 --> 00:18:52,480 THE PRESENTATION WILL BE ABOUT 556 00:18:52,480 --> 00:18:57,840 OUR NETWORK. 557 00:18:57,840 --> 00:19:02,120 THE EMOTIONAL WELL-BEING NETWORK 558 00:19:02,120 --> 00:19:04,480 IS A COLLABORATION AT THE 559 00:19:04,480 --> 00:19:08,080 UNIVERSITY OF ALABAMA AT 560 00:19:08,080 --> 00:19:09,840 BIRMINGHAM. 561 00:19:09,840 --> 00:19:13,320 THE MISSION OF OUR NETWORK IS TO 562 00:19:13,320 --> 00:19:15,760 DEVELOP CRITICAL KNOWLEDGE ABOUT 563 00:19:15,760 --> 00:19:18,280 THE IMPACT OF ECONOMIC BURDEN OF 564 00:19:18,280 --> 00:19:22,000 DISEASE ON EMOTIONAL WELL-BEING 565 00:19:22,000 --> 00:19:24,400 OF PATIENTS AND FAMILIES WITH 566 00:19:24,400 --> 00:19:25,600 THE ULTIMATE GOAL OF DEVELOPING 567 00:19:25,600 --> 00:19:30,000 THE STRATEGIES NEEDED TO REDUCE 568 00:19:30,000 --> 00:19:33,400 IT. 569 00:19:33,400 --> 00:19:37,000 OUR MISSION IS TO BE THE PREMIER 570 00:19:37,000 --> 00:19:39,280 GO-TO RESOURCE FOR RESEARCHERS 571 00:19:39,280 --> 00:19:42,760 WHO SEEK TO ADVANCE AND SUPPORT 572 00:19:42,760 --> 00:19:46,080 RESEARCH ON EMOTIONAL WELL-BEING 573 00:19:46,080 --> 00:19:47,720 AND COMMISSION BURDEN, AND ITS 574 00:19:47,720 --> 00:19:51,000 TRANSLATION INTO PUBLIC HEALTH 575 00:19:51,000 --> 00:19:52,560 POLICY, PATIENT ADVOCACY AND 576 00:19:52,560 --> 00:19:54,640 SUPPORT, AND INNOVATIONS IN 577 00:19:54,640 --> 00:20:01,880 HEALTHCARE DELIVERY. 578 00:20:01,880 --> 00:20:12,360 SO WHY IS OUR NETWORK NEEDED? IO 579 00:20:12,360 --> 00:20:14,120 YOU A CONCEPTUAL FRAMEWORK ABOUT 580 00:20:14,120 --> 00:20:16,120 THE ECONOMIC BURDEN OF CANCER. 581 00:20:16,120 --> 00:20:18,520 AND THIS COMES FROM A REVIEW 582 00:20:18,520 --> 00:20:20,160 PAPER BY DR. PISU AND 583 00:20:20,160 --> 00:20:21,040 COLLEAGUES. 584 00:20:21,040 --> 00:20:22,560 AS SEEN FROM THIS SLIDE, WHEN WE 585 00:20:22,560 --> 00:20:24,000 THINK ABOUT THE ECONOMIC BURDEN 586 00:20:24,000 --> 00:20:29,200 OF CANCER, THERE ARE TOLEDO E 587 00:20:29,200 --> 00:20:29,600 DOMAINS. 588 00:20:29,600 --> 00:20:32,120 WE HAVE DIRECT HEALTHCARE COSTS, 589 00:20:32,120 --> 00:20:34,640 WE HAVE DIRECT MEDICAL 590 00:20:34,640 --> 00:20:36,960 HEALTHCARE COSTS. 591 00:20:36,960 --> 00:20:38,480 SO FOR EXAMPLE, AMOUNT OF MONEY 592 00:20:38,480 --> 00:20:40,240 A PATIENT WOULD PAY TO A 593 00:20:40,240 --> 00:20:41,080 HEALTHCARE PROVIDER, A 594 00:20:41,080 --> 00:20:42,440 HEALTHCARE SYSTEM FOR CARE. 595 00:20:42,440 --> 00:20:44,400 WE ALSO HAVE NON-MEDICAL COSTS, 596 00:20:44,400 --> 00:20:48,880 SO FOR EXAMPLE, RESOURCES NEEDED 597 00:20:48,880 --> 00:20:51,080 TO GET YOU TO THAT MEDICAL CARE, 598 00:20:51,080 --> 00:20:52,800 SUCH AS TRANSPORTATION, AND THE 599 00:20:52,800 --> 00:20:57,960 COST ASSOCIATED WITH YOUR TIME 600 00:20:57,960 --> 00:20:58,960 RECEIVING THAT HEALTHCARE. 601 00:20:58,960 --> 00:21:00,520 WE ALSO HAVE INDIRECT COST, 602 00:21:00,520 --> 00:21:02,200 WHICH WE THINK OF AS 603 00:21:02,200 --> 00:21:02,880 PRODUCTIVITY LOSS. 604 00:21:02,880 --> 00:21:04,600 SO FOR INSTANCE, SOMEBODY WHO 605 00:21:04,600 --> 00:21:05,680 HAS REDUCED THE AMOUNT OF TIME 606 00:21:05,680 --> 00:21:08,040 THAT THEY WORK OR EVEN MAYBE 607 00:21:08,040 --> 00:21:10,240 COME OUT OF THE WORKING 608 00:21:10,240 --> 00:21:10,680 ENVIRONMENT ENTIRELY. 609 00:21:10,680 --> 00:21:12,760 AND THEN WE HAVE PSYCHOSOCIAL 610 00:21:12,760 --> 00:21:15,040 COSTS, THE QUALITY OF LIFE 611 00:21:15,040 --> 00:21:17,480 LOSSES THAT ARE A CONSEQUENCE OF 612 00:21:17,480 --> 00:21:25,000 THE ECONOMIC BURDEN OF CANCER. 613 00:21:25,000 --> 00:21:28,160 THE RESEARCH HIGHLIGHTS THAM THE 614 00:21:28,160 --> 00:21:29,400 FINANCIAL BURDEN ON INDIVIDUALS 615 00:21:29,400 --> 00:21:34,640 SECONDARY TO ILLNESS IS 616 00:21:34,640 --> 00:21:37,240 PROFOUND. 617 00:21:37,240 --> 00:21:38,600 ON THIS SLIDE, I'M GOING TO 618 00:21:38,600 --> 00:21:41,280 HIGHLIGHT JUST A FEW PAPERS THAT 619 00:21:41,280 --> 00:21:42,960 HAVE EXAMINED THIS ISSUE. 620 00:21:42,960 --> 00:21:44,920 THIS FIRST PAPER THAT APPEARED 621 00:21:44,920 --> 00:21:46,240 IN THE JOURNAL OF CLINICAL 622 00:21:46,240 --> 00:21:49,080 ONCOLOGY BY DR. RAMSEY AND 623 00:21:49,080 --> 00:21:52,480 COLLEAGUES FOUND THAT 624 00:21:52,480 --> 00:21:53,800 INDIVIDUALS WHO HAD A DIAGNOSIS 625 00:21:53,800 --> 00:21:58,720 OF A CANCER AND THEN HAS 626 00:21:58,720 --> 00:21:59,840 SUBSEQUENTLY DECLARED BANKRUPTCY 627 00:21:59,840 --> 00:22:01,480 ARE MORE LIKELY TO DIE SOONER 628 00:22:01,480 --> 00:22:05,200 THAN THEIR PEERS, WHO ALSO HAD 629 00:22:05,200 --> 00:22:07,280 CANCER THAT DID NOT DECLARE 630 00:22:07,280 --> 00:22:07,800 BANKRUPTCY. 631 00:22:07,800 --> 00:22:11,600 THIS WAS A STUDY DONE IN 632 00:22:11,600 --> 00:22:13,000 WASHINGTON STATE, THEY MATCHED 633 00:22:13,000 --> 00:22:14,840 CANCER PATIENTS WHO HAD DECLARED 634 00:22:14,840 --> 00:22:16,360 BANKRUPTCY WITH THOSE WHO HAD 635 00:22:16,360 --> 00:22:18,240 NOT ON DEMOGRAPHIC AND CLINICAL 636 00:22:18,240 --> 00:22:18,440 FACTORS. 637 00:22:18,440 --> 00:22:22,160 AND THEN THEY ASKED THIS 638 00:22:22,160 --> 00:22:22,680 QUESTION. 639 00:22:22,680 --> 00:22:23,840 AGAIN, THEY FOUND THOSE WHO 640 00:22:23,840 --> 00:22:29,440 FILED FOR BANKRUPTCY WERE AT 641 00:22:29,440 --> 00:22:31,880 GREATER RISK TO EARLY MORTALITY. 642 00:22:31,880 --> 00:22:33,320 THIS SPEAKS TO THE IMPORTANCE OF 643 00:22:33,320 --> 00:22:34,560 TRYING TO UNDERSTAND THE 644 00:22:34,560 --> 00:22:35,440 MECHANISMS BETWEEN FINANCIAL 645 00:22:35,440 --> 00:22:39,680 BURDEN AND MORTALITY AND 646 00:22:39,680 --> 00:22:40,920 SURVIVAL. 647 00:22:40,920 --> 00:22:42,120 IMPORTANTLY FOR THIS STUDY IN 648 00:22:42,120 --> 00:22:44,080 THOSE TWO GROUPS, CANCER 649 00:22:44,080 --> 00:22:49,360 PATIENTS HAD RECEIVED SIMILAR 650 00:22:49,360 --> 00:22:50,560 INITIAL TREATMENT SO IT DOES NOT 651 00:22:50,560 --> 00:22:51,960 SEEM TO BE ACCOUNTED FOR BY 652 00:22:51,960 --> 00:22:56,760 DIFFERENCES IN TREATMENT. 653 00:22:56,760 --> 00:23:04,120 THIS NEXT PAPER, NATIONAL USED M 654 00:23:04,120 --> 00:23:07,920 THE HEALTH AND RETIREMENT STUDY. 655 00:23:07,920 --> 00:23:12,880 THEY FOUND THAT TWO YEARS AFTER 656 00:23:12,880 --> 00:23:14,960 DIAGNOSIS, 42% OF CANCER 657 00:23:14,960 --> 00:23:18,520 SURVIVORS HAD DEPLETED THEIR NET 658 00:23:18,520 --> 00:23:19,800 WORTH AS WELL AS DECREASING DEBT 659 00:23:19,800 --> 00:23:22,000 IN A NUMBER OF OTHER CATEGORIES 660 00:23:22,000 --> 00:23:23,760 INCLUDING CONSUMER DEBT AS A 661 00:23:23,760 --> 00:23:29,120 RESULT OF HAVING CANCER. 662 00:23:29,120 --> 00:23:32,480 THIS NEXT PAPER, FANGS HARDSHIP 663 00:23:32,480 --> 00:23:35,920 IN USED DATA FROM 664 00:23:35,920 --> 00:23:36,920 THE NATIONAL INTERVIEW HEALTH 665 00:23:36,920 --> 00:23:38,720 STUDY AND THEY LOOKED AT DATA 666 00:23:38,720 --> 00:23:41,560 ACROSS AGE RANGES, SO YOUNGER 667 00:23:41,560 --> 00:23:42,920 ADULTS AND OLDER ADULTS AND 668 00:23:42,920 --> 00:23:45,080 FOUND THAT MEDICAL FINANCIAL 669 00:23:45,080 --> 00:23:45,960 HARDSHIP WAS COMMON. 670 00:23:45,960 --> 00:23:47,360 IN FACT, THEY HAD SOME VERY 671 00:23:47,360 --> 00:23:49,880 IMPORTANT FINDINGS AS RELATES TO 672 00:23:49,880 --> 00:23:50,680 EMOTIONAL HEALTH AND SO I'M 673 00:23:50,680 --> 00:23:51,800 GOING TO TALK ABOUT THIS PAPER A 674 00:23:51,800 --> 00:23:52,920 LITTLE BIT MORE IN THE NEXT FEW 675 00:23:52,920 --> 00:23:56,800 SLIDES. 676 00:23:56,800 --> 00:24:06,080 THIS NEXT PAPER CONDUCTED D 677 00:24:06,080 --> 00:24:08,960 EXTENSIVE FINANCIAL HARDSHIP 678 00:24:08,960 --> 00:24:10,320 AMONG GYNECOLOGICAL CANCER 679 00:24:10,320 --> 00:24:12,480 PATIENTS STARTING A NEW LINE OF 680 00:24:12,480 --> 00:24:12,920 THERAPY. 681 00:24:12,920 --> 00:24:14,400 ACCORDING TO THE STUDY, 74% OF 682 00:24:14,400 --> 00:24:15,680 THE PARTICIPANTS HAD PRIVATE 683 00:24:15,680 --> 00:24:19,680 INSURANCE. 684 00:24:19,680 --> 00:24:21,760 NONETHELESS, 54% REPORTED 685 00:24:21,760 --> 00:24:22,960 FINANCIAL DISTRESS, AND THIS WAS 686 00:24:22,960 --> 00:24:24,520 A MEASURE THAT ASKED QUESTIONS 687 00:24:24,520 --> 00:24:27,640 SUCH AS, MY CANCER OR TREATMENT 688 00:24:27,640 --> 00:24:30,640 HAS REDUCED MY SATISFACTION WITH 689 00:24:30,640 --> 00:24:32,520 MY PRESENT FINANCIAL SITUATION. 690 00:24:32,520 --> 00:24:33,440 I WORRY ABOUT THE FINANCIAL 691 00:24:33,440 --> 00:24:35,160 PROBLEMS I WILL HAVE IN THE 692 00:24:35,160 --> 00:24:37,000 FUTURE AS A RESULT OF MY ILLNESS 693 00:24:37,000 --> 00:24:39,480 OR TREATMENT. 694 00:24:39,480 --> 00:24:41,080 I FEEL I HAVE NO CHOICE ABOUT 695 00:24:41,080 --> 00:24:42,520 THE AMOUNT OF MONEY I SPEND ON 696 00:24:42,520 --> 00:24:47,040 CARE. 697 00:24:47,040 --> 00:24:48,520 IN THIS NEXT PAPER WE DID A FEW 698 00:24:48,520 --> 00:24:51,280 YEARS AGO, WE EXAMINED WHAT 699 00:24:51,280 --> 00:24:52,840 PATIENTS WORRY ABOUT MAKING 700 00:24:52,840 --> 00:24:55,400 DECISIONS, AND OUR STUDY FOUND 701 00:24:55,400 --> 00:24:59,400 THAT 40% OF PATIENTS WITH CANCER 702 00:24:59,400 --> 00:25:02,480 WHEN MAKING DECISIONS WORRIED 703 00:25:02,480 --> 00:25:04,800 ABOUT THE COST OF CARE. 704 00:25:04,800 --> 00:25:07,080 AND THIS IS IN A NATIONAL SAMPLE 705 00:25:07,080 --> 00:25:09,160 OF OVER 5,000 CANCER SURVIVORS. 706 00:25:09,160 --> 00:25:11,480 WE ALSO FOUND THAT THOSE WHO 707 00:25:11,480 --> 00:25:14,080 PERCEIVED THEIR HEALTH AS LESS 708 00:25:14,080 --> 00:25:16,520 THAN EXCELLENT AND THOSE WITH 709 00:25:16,520 --> 00:25:18,200 MORE ADVANCED CANCER DIAGNOSIS 710 00:25:18,200 --> 00:25:22,840 WERE MORE LIKELY TO WORRY AS 711 00:25:22,840 --> 00:25:24,160 WELL. 712 00:25:24,160 --> 00:25:25,800 AS PROMISED, I WANTED TO DIG A 713 00:25:25,800 --> 00:25:27,360 LITTLE BIT DEEPER WITH ONE OF 714 00:25:27,360 --> 00:25:28,440 THOSE PAPERS, AS I THINK IT IS 715 00:25:28,440 --> 00:25:30,200 VERY TELLING WHEN WE THINK ABOUT 716 00:25:30,200 --> 00:25:32,800 ONE'S EMOTIONAL HEALTH, AND THE 717 00:25:32,800 --> 00:25:34,680 BURDEN OF CANCER. 718 00:25:34,680 --> 00:25:37,440 IN THIS PAPER, THEY DEFINED 719 00:25:37,440 --> 00:25:40,240 HARDSHIP IN THREE WAYS. 720 00:25:40,240 --> 00:25:41,440 YOU HAD MATERIAL HARDSHIP, 721 00:25:41,440 --> 00:25:43,320 PROBLEMS PAYING MEDICAL BILLS 722 00:25:43,320 --> 00:25:46,200 AND/OR PAYING OFF MEDICAL BILLS, 723 00:25:46,200 --> 00:25:49,360 YOU HAD PSYCHOLOGICAL HARDSHIP, 724 00:25:49,360 --> 00:25:50,960 WORRY ABOUT PAYING COST OF 725 00:25:50,960 --> 00:25:54,360 SERIOUS ILLNESS AND/OR NORMAL 726 00:25:54,360 --> 00:25:55,480 HEALTHCARE, AND THERE IS 727 00:25:55,480 --> 00:25:57,880 BEHAVIORAL HARDSHIP, DELAYING 728 00:25:57,880 --> 00:25:59,200 AND/OR FOREGOING CARE DUE TO 729 00:25:59,200 --> 00:26:01,600 WORRY ABOUT COST AND/OR BEING 730 00:26:01,600 --> 00:26:07,440 UNABLE TO AFFORD NEEDED CARE. 731 00:26:07,440 --> 00:26:11,040 IN THIS FIRST FIGURE FROM THE 732 00:26:11,040 --> 00:26:14,640 TABLE, IT'S ANY MATERIAL, 733 00:26:14,640 --> 00:26:16,320 PSYCHOLOGICAL OR BEHAVIORAL 734 00:26:16,320 --> 00:26:18,160 MEDICAL FINANCIAL HARDSHIP BY 735 00:26:18,160 --> 00:26:20,080 AGE GROUP. 736 00:26:20,080 --> 00:26:21,360 AND THE AGE GROUP COMPARISONS 737 00:26:21,360 --> 00:26:22,520 WERE ALL SIGNIFICANT. 738 00:26:22,520 --> 00:26:24,840 INTERESTINGLY AS YOU SEE HERE, 739 00:26:24,840 --> 00:26:27,880 THE HARDSHIP WAS REALLY GREATEST 740 00:26:27,880 --> 00:26:30,160 IN THE PSYCHOLOGICAL REALM. 741 00:26:30,160 --> 00:26:31,360 ESPECIALLY FOR THE YOUNGER 742 00:26:31,360 --> 00:26:39,080 POPULATION. 743 00:26:39,080 --> 00:26:40,760 NEXT FIGURE LOOKED AT THE 744 00:26:40,760 --> 00:26:42,080 PERCENTAGE OF ANY MATERIAL 745 00:26:42,080 --> 00:26:45,120 FINANCIAL HARDSHIP, THEY DID SO 746 00:26:45,120 --> 00:26:47,000 BETTER BY AGE BUT BY INSURANCE 747 00:26:47,000 --> 00:26:48,000 STATUS, WITH THE BLUE BEING ALSO 748 00:26:48,000 --> 00:26:51,920 THE YOUNGER POPULATION. 749 00:26:51,920 --> 00:26:54,320 INDICATING THE OLDER POPULATION. 750 00:26:54,320 --> 00:26:57,280 SO AS YOU CAN SEE THE UNINSURED, 751 00:26:57,280 --> 00:26:59,120 WHILE THEY DID HAVE THE HIGHEST 752 00:26:59,120 --> 00:27:00,320 PERCENTAGE OF ANY MATERIAL 753 00:27:00,320 --> 00:27:03,960 FINANCIAL HARDSHIP, THERE WAS 754 00:27:03,960 --> 00:27:09,760 HARDSHIP ACROSS ALL TYPES OF 755 00:27:09,760 --> 00:27:12,400 INSURANCE STATUS. 756 00:27:12,400 --> 00:27:13,960 NEXT SLIDE AGAIN PRESENTS THE 757 00:27:13,960 --> 00:27:17,480 DATA BY INSURANCE STATUS, AND IT 758 00:27:17,480 --> 00:27:19,080 EXAMINES PSYCHOLOGICAL HARDSHIP. 759 00:27:19,080 --> 00:27:23,080 AND AS YOU CAN SEE, AMONG THE 760 00:27:23,080 --> 00:27:23,880 UNINSURED, ON THE LEFT SIDE OF 761 00:27:23,880 --> 00:27:26,360 THIS SLIDE, 71% HAD 762 00:27:26,360 --> 00:27:27,560 PSYCHOLOGICAL CONCERNS AS 763 00:27:27,560 --> 00:27:31,200 RELATED TO THEIR FINANCES. 764 00:27:31,200 --> 00:27:34,520 EVEN THOSE AMONG PRIVATE AND 765 00:27:34,520 --> 00:27:35,760 PUBLIC ONLY INSURANCE SIMILARLY 766 00:27:35,760 --> 00:27:40,080 HAD HIGH RATES OF PSYCHOLOGICAL 767 00:27:40,080 --> 00:27:40,560 DISTRESS. 768 00:27:40,560 --> 00:27:42,200 THIS LAST ONE IS BEHAVIORAL 769 00:27:42,200 --> 00:27:42,600 HARDSHIP. 770 00:27:42,600 --> 00:27:44,040 AND AGAIN, YOU'LL SEE SIMILAR 771 00:27:44,040 --> 00:27:45,240 PATTERNS OF THOSE WHO ARE 772 00:27:45,240 --> 00:27:47,800 UNINSURED, HAVING HIGHER RATES 773 00:27:47,800 --> 00:27:51,400 THAT THOSE WHO DO HAVE INSURANCE 774 00:27:51,400 --> 00:27:52,800 ARE STILL PRESENTING WITH 775 00:27:52,800 --> 00:27:57,400 CONCERNS RELATED TO THIS TOPIC. 776 00:27:57,400 --> 00:28:01,000 SO THE ECONOMIC BURDEN OF 777 00:28:01,000 --> 00:28:02,120 DISEASE IMPACTS ONE'S EMOTIONAL 778 00:28:02,120 --> 00:28:09,000 HEALTH. 779 00:28:09,000 --> 00:28:10,120 QUESTIONS REMAIN, AT LEAST FOR 780 00:28:10,120 --> 00:28:10,760 US, THEY DID. 781 00:28:10,760 --> 00:28:12,160 WE WERE CURIOUS, WHAT ARE THE 782 00:28:12,160 --> 00:28:13,960 CORE COMPONENTS OF EMOTIONAL 783 00:28:13,960 --> 00:28:15,240 WELL-BEING, ESPECIALLY IN THIS 784 00:28:15,240 --> 00:28:19,040 CONTEXT OF ECONOMIC BURDEN OF 785 00:28:19,040 --> 00:28:19,280 DISEASE. 786 00:28:19,280 --> 00:28:20,800 AND HOW IS EMOTIONAL WELL-BEING 787 00:28:20,800 --> 00:28:22,240 DIFFERENT FROM WORRY, 788 00:28:22,240 --> 00:28:24,000 PSYCHOLOGICAL HARDSHIP, 789 00:28:24,000 --> 00:28:27,840 FINANCIAL DISTRESS, QUALITY OF 790 00:28:27,840 --> 00:28:28,120 LIFE. 791 00:28:28,120 --> 00:28:28,920 YOU'VE PROBABLY NOTICED THAT IN 792 00:28:28,920 --> 00:28:30,240 MY EARLIER COMMENTS AND AS I 793 00:28:30,240 --> 00:28:32,080 TALKED ABOUT STUDIES, DIFFERENT 794 00:28:32,080 --> 00:28:33,520 TERMS WERE USED. 795 00:28:33,520 --> 00:28:35,160 ARE WE TALKING ABOUT THE SAME 796 00:28:35,160 --> 00:28:38,520 THING OR ARE THEY CONCEPTUALLY 797 00:28:38,520 --> 00:28:39,160 DISTINCT? 798 00:28:39,160 --> 00:28:40,840 SPECIFICALLY ARE THEY 799 00:28:40,840 --> 00:28:42,160 CONCEPTUALLY DISTINCT FROM 800 00:28:42,160 --> 00:28:48,080 EMOTIONAL WELL-BEING. 801 00:28:48,080 --> 00:28:49,400 WHAT LINKS FINANCIAL BURDEN WITH 802 00:28:49,400 --> 00:28:50,400 HEALTH OUTCOMES? 803 00:28:50,400 --> 00:28:52,600 AND CAN WE PREVENT THE HARMFUL 804 00:28:52,600 --> 00:28:54,200 EFFECTS OF ECONOMIC BURDEN ON 805 00:28:54,200 --> 00:29:00,240 ONE'S EMOTIONAL WELL-BEING? 806 00:29:00,240 --> 00:29:02,680 SO TO ANSWER THOSE QUESTIONS, 807 00:29:02,680 --> 00:29:05,200 DR. PISU AND I REALLY THOUGHT 808 00:29:05,200 --> 00:29:08,040 ABOUT IT AND PUT TOGETHER THE 809 00:29:08,040 --> 00:29:09,480 GRANT AND RESPONSE TO THE 810 00:29:09,480 --> 00:29:10,520 FUNDING OPPORTUNITY, AND WE'RE 811 00:29:10,520 --> 00:29:12,520 SO GRATEFUL TO BE FUNDED TO 812 00:29:12,520 --> 00:29:15,360 ESTABLISH THIS NETWORK. 813 00:29:15,360 --> 00:29:16,680 WE PLAN TO BE ABLE TO ANSWER 814 00:29:16,680 --> 00:29:19,600 THOSE QUESTIONS AND MORE BY 815 00:29:19,600 --> 00:29:23,240 PURSUING THREE AIMS. 816 00:29:23,240 --> 00:29:25,600 OUR FIRST AIM IS TO ESTABLISH A 817 00:29:25,600 --> 00:29:27,720 MULTIDISCIPLINARY NETWORK OF 818 00:29:27,720 --> 00:29:30,040 RESEARCHERS, PATIENTS, 819 00:29:30,040 --> 00:29:31,560 CAREGIVERS, HEALTHCARE 820 00:29:31,560 --> 00:29:34,600 PROVIDERS, AND OTHERS, 821 00:29:34,600 --> 00:29:35,840 INTERESTED IN THE TOPIC AND 822 00:29:35,840 --> 00:29:37,480 INTERESTED IN ADVANCING THE 823 00:29:37,480 --> 00:29:37,680 FIELD. 824 00:29:37,680 --> 00:29:39,520 IT WAS VERY, VERY IMPORTANT TO 825 00:29:39,520 --> 00:29:41,440 US THAT WE BROUGHT MANY 826 00:29:41,440 --> 00:29:44,040 INDIVIDUALS TO THE TABLE THAT 827 00:29:44,040 --> 00:29:45,680 CAME WITH DIFFERENT PERSPECTIVES 828 00:29:45,680 --> 00:29:50,360 AND DIFFERENT EXPERIENCES. 829 00:29:50,360 --> 00:29:51,160 ESPECIALLY PATIENTS AND 830 00:29:51,160 --> 00:29:52,440 CAREGIVERS WHO ARE AFFECTED BY 831 00:29:52,440 --> 00:29:54,760 THE ECONOMIC BURDEN OF DISEASE. 832 00:29:54,760 --> 00:29:56,600 AND WHILE OUR WORK PRIMARILY HAS 833 00:29:56,600 --> 00:29:59,000 BEEN DONE IN CANCER AND WHILE 834 00:29:59,000 --> 00:30:00,800 THE ECONOMIC BURDEN OF DISEASE 835 00:30:00,800 --> 00:30:03,080 TO DATE HAS BEEN PRIMARILY DONE 836 00:30:03,080 --> 00:30:04,280 IN CANCER, THIS NETWORK IS 837 00:30:04,280 --> 00:30:05,840 INTERESTED IN UNDERSTANDING THE 838 00:30:05,840 --> 00:30:07,120 DISEASE BURDEN ACROSS MANY 839 00:30:07,120 --> 00:30:10,400 DISEASES. 840 00:30:10,400 --> 00:30:13,040 ECONOMIC BURDEN. 841 00:30:13,040 --> 00:30:16,720 THE SECOND AIM IS TO IMPLEMENT A 842 00:30:16,720 --> 00:30:18,720 PILOT PROJECT PROGRAM OPEN TO 843 00:30:18,720 --> 00:30:19,440 INVESTIGATORS ACROSS THE 844 00:30:19,440 --> 00:30:20,720 COUNTRY. 845 00:30:20,720 --> 00:30:22,040 AND SO WE'RE REALLY EXCITE TODAY 846 00:30:22,040 --> 00:30:24,440 HAVE THE OPPORTUNITY TO ADVANCE 847 00:30:24,440 --> 00:30:30,240 RESEARCHERS IN A VERY TANGIBLE 848 00:30:30,240 --> 00:30:33,680 WAY WITH PROJECTS IN THIS AREA. 849 00:30:33,680 --> 00:30:36,520 AND OUR THIRD AIM IS TO DEVELOP 850 00:30:36,520 --> 00:30:40,080 AND TO SHARE RESOURCES. 851 00:30:40,080 --> 00:30:42,080 SO WE'VE RECENTLY LAUNCHED A 852 00:30:42,080 --> 00:30:48,080 SEMINAR SERIES THAT ALLOWS 853 00:30:48,080 --> 00:30:50,240 INDIVIDUALS TO ATTEND VIRTUALLY 854 00:30:50,240 --> 00:30:51,120 TO LEARN ABOUT THE ECONOMIC 855 00:30:51,120 --> 00:30:54,480 BURDEN OF TEASE DISEASE AND L 856 00:30:54,480 --> 00:30:54,920 WELL-BEING. 857 00:30:54,920 --> 00:30:55,920 WE HAVE A WEBSITE THAT INCLUDES 858 00:30:55,920 --> 00:30:57,800 A SEARCHABLE LITERATURE DATABASE 859 00:30:57,800 --> 00:30:59,280 ON TOPICS THAT ARE RELEVANT TO 860 00:30:59,280 --> 00:31:00,360 THE NETWORK. 861 00:31:00,360 --> 00:31:02,880 WE HOPE TO HAVE A REPOSITORY OF 862 00:31:02,880 --> 00:31:04,200 MEASUREMENT TOOLS, AND WE'RE 863 00:31:04,200 --> 00:31:07,800 ABOUT TO LAUNCH A FIND A 864 00:31:07,800 --> 00:31:08,840 COLLABORATOR FUNCTION, WHERE IN 865 00:31:08,840 --> 00:31:10,040 IF THERE'S A HEALTHCARE PROVIDER 866 00:31:10,040 --> 00:31:11,440 OR A PATIENT OR INVESTIGATOR WHO 867 00:31:11,440 --> 00:31:13,040 WANTS TO WORK IN THIS AREA BUT 868 00:31:13,040 --> 00:31:15,120 DOES NOT KNOW WHO TO WORK WITH, 869 00:31:15,120 --> 00:31:16,800 WE CAN TRY TO DO SOME 870 00:31:16,800 --> 00:31:18,080 MATCHMAKING. 871 00:31:18,080 --> 00:31:22,280 WE'LL ALSO HAVE SCIENTIFIC 872 00:31:22,280 --> 00:31:28,720 MEETINGS. 873 00:31:28,720 --> 00:31:30,680 SO WE ALSO FELT IT IMPORTANT TO 874 00:31:30,680 --> 00:31:32,400 FOCUS ON THREE AREAS FOR OUR 875 00:31:32,400 --> 00:31:33,840 NETWORK. 876 00:31:33,840 --> 00:31:38,640 OUR FIRST AREA OF FOCUS IS ON 877 00:31:38,640 --> 00:31:39,840 ONTOLOGY AND MEASUREMENT OF 878 00:31:39,840 --> 00:31:40,840 EMOTIONAL WELL-BEING, TO REALLY 879 00:31:40,840 --> 00:31:42,400 TRY TO UNDERSTAND WHAT ARE THOSE 880 00:31:42,400 --> 00:31:44,680 CORE COMPONENTS OF EMOTIONAL 881 00:31:44,680 --> 00:31:45,560 WELL-BEING, PARTICULARLY IN THE 882 00:31:45,560 --> 00:31:47,720 CONTEXT OF ECONOMIC BURDEN OF 883 00:31:47,720 --> 00:31:48,920 DISEASE, AND HOW SHOULD WE 884 00:31:48,920 --> 00:31:51,880 MEASURE IT. 885 00:31:51,880 --> 00:31:53,960 WE'RE ALSO VERY INTERESTED IN 886 00:31:53,960 --> 00:31:54,760 PRIORITIZING MECHANISTIC 887 00:31:54,760 --> 00:31:56,360 RESEARCH ON THE ROLE OF 888 00:31:56,360 --> 00:31:57,480 EMOTIONAL WELL-BEING IN HEALTH. 889 00:31:57,480 --> 00:31:59,320 SO HOW DO WE CONNECT THE DOTS, 890 00:31:59,320 --> 00:32:01,840 HOW DOES EMOTIONAL WELL-BEING 891 00:32:01,840 --> 00:32:03,520 PROMOTE GOOD HEALTH OUTCOMES, 892 00:32:03,520 --> 00:32:05,360 AND WHAT ROLE DOES ECONOMIC 893 00:32:05,360 --> 00:32:10,480 BURDEN OF DISEASE PLAY IN THOSE 894 00:32:10,480 --> 00:32:10,800 RELATIONSHIPS. 895 00:32:10,800 --> 00:32:11,800 VERY IMPORTANT TO US, PREVENTION 896 00:32:11,800 --> 00:32:12,160 RESEARCH. 897 00:32:12,160 --> 00:32:14,400 IF WE COULD DECREASE THE BURDEN, 898 00:32:14,400 --> 00:32:15,520 THE ECONOMIC BURDEN OF DISEASE 899 00:32:15,520 --> 00:32:18,240 IN TERMS OF ONE'S EMOTIONAL 900 00:32:18,240 --> 00:32:20,080 WELL-BEING, WE WOULD BE THRILLED 901 00:32:20,080 --> 00:32:21,760 TO BE ABLE TO ADVANCE RESEARCH 902 00:32:21,760 --> 00:32:29,640 IN THIS WAY. 903 00:32:29,640 --> 00:32:31,280 SO WE BEGAN OUR JOURNEY WITH THE 904 00:32:31,280 --> 00:32:33,360 DEFINITION PROVIDED BY THE 905 00:32:33,360 --> 00:32:35,440 INSTITUTE AND IN THE FUNDING 906 00:32:35,440 --> 00:32:36,640 OPPORTUNITY, AND DEFINING 907 00:32:36,640 --> 00:32:38,320 EMOTIONAL WELL-BEING AS AN 908 00:32:38,320 --> 00:32:44,640 OVERALL POSITIVE STATE OF ONE'S 909 00:32:44,640 --> 00:32:45,400 EMOTIONS, LIFE SATISFACTION, 910 00:32:45,400 --> 00:32:47,400 SENSE OF MEANING AND PURPOSE, 911 00:32:47,400 --> 00:32:50,560 AND ABILITY TO PURSUE DEFINED 912 00:32:50,560 --> 00:32:51,520 GOALS. 913 00:32:51,520 --> 00:32:52,840 SINCE FUNDING, WE'VE HL THE 914 00:32:52,840 --> 00:32:53,520 GREAT OPPORTUNITY TO WORK WITH 915 00:32:53,520 --> 00:32:54,480 THE OTHER NETWORKS THAT HAVE 916 00:32:54,480 --> 00:32:55,600 BEEN FUNDED TO REALLY THINK 917 00:32:55,600 --> 00:32:59,760 ABOUT HOW WE MIGHT REFINE THIS 918 00:32:59,760 --> 00:33:00,840 DEFINITION AND HOPEFULLY WE'LL 919 00:33:00,840 --> 00:33:02,720 BE SHARING THAT WITH YOU MORE 920 00:33:02,720 --> 00:33:05,440 BROADLY SOON. 921 00:33:05,440 --> 00:33:07,520 OUR WORK IS ALSO GUIDED BY A 922 00:33:07,520 --> 00:33:11,280 CONCEPTUAL FRAMEWORK, BUILDING 923 00:33:11,280 --> 00:33:15,160 ON THE LAZARUS MODEL OF STRESS 924 00:33:15,160 --> 00:33:17,000 APPRAISAL AND COPING AND SOME OF 925 00:33:17,000 --> 00:33:19,600 OUR EMOTIONAL -- HAS BEEN 926 00:33:19,600 --> 00:33:26,040 INFORMED BY SOME WORK BY 927 00:33:26,040 --> 00:33:29,000 DR. HEAD WHO WROTE A PAPER, AS 928 00:33:29,000 --> 00:33:30,240 IF THE DISEASE WAS NOT ENOUGH, 929 00:33:30,240 --> 00:33:31,280 COPING WITH THE FINANCIAL 930 00:33:31,280 --> 00:33:32,840 CONSEQUENCES OF CANCER. 931 00:33:32,840 --> 00:33:33,920 SO WE'LL TAKE A MOMENT TO SPEND 932 00:33:33,920 --> 00:33:34,880 SOME TIME HERE AND GO THROUGH 933 00:33:34,880 --> 00:33:37,120 THIS FRAMEWORK, AND IT'S OUR 934 00:33:37,120 --> 00:33:39,600 HOPE THAT OF THE NETWORK THAT 935 00:33:39,600 --> 00:33:41,600 THE RESEARCH WE GENERATE REALLY 936 00:33:41,600 --> 00:33:43,520 COULD REFINE THIS FRAMEWORK AND 937 00:33:43,520 --> 00:33:44,760 HE 938 00:33:44,760 --> 00:33:46,280 MAYBE ADD TO IT AND EXPAND TO IT 939 00:33:46,280 --> 00:33:49,000 IN IMPORTANT WAYS. 940 00:33:49,000 --> 00:33:49,920 SO THINK ABOUT THE ECONOMIC 941 00:33:49,920 --> 00:33:52,960 BURDEN OF DISEASE AS A POTENTIAL 942 00:33:52,960 --> 00:33:53,600 STRESSOR, SO ON THE LEFT-HAND 943 00:33:53,600 --> 00:33:54,600 SIDE WITH THE RED CIRCLE IS 944 00:33:54,600 --> 00:33:55,920 WHERE WE WOULD PLACE THE 945 00:33:55,920 --> 00:33:58,000 ECONOMIC BURDEN OF DISEASE. 946 00:33:58,000 --> 00:34:02,280 AND WE ANTICIPATE THAT 947 00:34:02,280 --> 00:34:03,560 INDIVIDUALS FIRST ENGAGE IN A 948 00:34:03,560 --> 00:34:06,520 PRIMARY APPRAISAL OF THAT 949 00:34:06,520 --> 00:34:07,720 BURDEN, SO IS THAT BURDEN 950 00:34:07,720 --> 00:34:10,480 RELEVANT TO ME, IS IT STRESSFUL, 951 00:34:10,480 --> 00:34:13,200 DO I HAVE THE RESOURCES TO 952 00:34:13,200 --> 00:34:16,240 ADDRESS IT. 953 00:34:16,240 --> 00:34:19,120 AND WE REALLY WANT TO UNDERSTAND 954 00:34:19,120 --> 00:34:20,520 WHAT FACTORS INFLUENCE THAT 955 00:34:20,520 --> 00:34:22,400 PRIMARY APPRAISAL. 956 00:34:22,400 --> 00:34:24,560 SO THE FACT IS, WE'VE STARTED 957 00:34:24,560 --> 00:34:26,000 WITH, AS OUR BEGINNING WORKING 958 00:34:26,000 --> 00:34:29,080 MODEL, INCLUDES HEALTH, SO ONE'S 959 00:34:29,080 --> 00:34:30,520 SELF-PERCEIVED HEALTH, MAYBE 960 00:34:30,520 --> 00:34:31,920 OTHER COMORBIDITIES, MIGHT 961 00:34:31,920 --> 00:34:33,000 INFLUENCE WHETHER OR NOT YOU SEE 962 00:34:33,000 --> 00:34:34,520 THIS ECONOMIC BURDEN OF DISEASE 963 00:34:34,520 --> 00:34:37,840 AS SOMETHING THAT IS STRESSFUL. 964 00:34:37,840 --> 00:34:40,000 DEMOGRAPHIC VARIABLES SUCH AS 965 00:34:40,000 --> 00:34:43,840 YOUR AGE, RACE/ETHNICITY AND 966 00:34:43,840 --> 00:34:45,280 GENDER, SOCIAL VARIABLES SUCH AS 967 00:34:45,280 --> 00:34:47,320 ONE'S SOCIAL SUPPORT NETWORK, 968 00:34:47,320 --> 00:34:49,560 THE SIZE OF THE NETWORK MIGHT 969 00:34:49,560 --> 00:34:51,800 INFLUENCE WHETHER OR NOT YOU SEE 970 00:34:51,800 --> 00:34:54,120 THAT ECONOMIC BURDEN AS 971 00:34:54,120 --> 00:34:55,200 STRESSFUL. 972 00:34:55,200 --> 00:34:56,400 SOCIOECONOMIC FACTORS SUCH AS 973 00:34:56,400 --> 00:34:57,960 EDUCATION, YOUR INCOME AND 974 00:34:57,960 --> 00:34:59,000 SAVINGS, THE NUMBER OF 975 00:34:59,000 --> 00:35:00,080 INDIVIDUALS THAT YOU SUPPORT 976 00:35:00,080 --> 00:35:04,640 WITH YOUR INCOME, YOUR HEALTH 977 00:35:04,640 --> 00:35:04,920 INSURANCE. 978 00:35:04,920 --> 00:35:07,680 AND PSYCH LOGIC CONSIDERATIONS 979 00:35:07,680 --> 00:35:09,720 SUCH AS STIGMA, WHETHER IT BE 980 00:35:09,720 --> 00:35:11,360 STIGMA RELATED TO YOUR DISEASE 981 00:35:11,360 --> 00:35:13,040 OR STIGMA RELATED TO FEELING 982 00:35:13,040 --> 00:35:15,080 THAT YOU'RE UNABLE TO AFFORD THE 983 00:35:15,080 --> 00:35:18,320 CARE THAT YOU DESIRE. 984 00:35:18,320 --> 00:35:22,360 FINANCIAL DISTRESS, YOUR WORRY, 985 00:35:22,360 --> 00:35:25,160 ABILITY TO DEAL WITH 986 00:35:25,160 --> 00:35:28,040 UNCERTAINTY, VALUES AND BELIEFS 987 00:35:28,040 --> 00:35:28,560 AND SHAME. 988 00:35:28,560 --> 00:35:30,320 ALL THESE VARIABLES REALLY NEED 989 00:35:30,320 --> 00:35:31,600 TO BE STUDIED TO SEE WHAT ROLE 990 00:35:31,600 --> 00:35:33,600 THEY PLAY, IF ANY, IN ONE'S 991 00:35:33,600 --> 00:35:35,680 PRIMARY APPRAISAL. 992 00:35:35,680 --> 00:35:37,320 OUR SECOND AREA OF APPRAISAL 993 00:35:37,320 --> 00:35:38,520 REALLY INVOLVES THINKING ABOUT 994 00:35:38,520 --> 00:35:40,600 WHAT ONE WILL DO WITH THE 995 00:35:40,600 --> 00:35:43,120 PROBLEM OF ECONOMIC BURDEN. 996 00:35:43,120 --> 00:35:47,840 AND WE CONCEPTIZED IT AS EMOTION 997 00:35:47,840 --> 00:35:50,720 FOCUSED COPING AND PROBLEM 998 00:35:50,720 --> 00:35:51,640 FOCUSED COPING. 999 00:35:51,640 --> 00:35:53,840 EMOTION FOCUSED COPING INCLUDES 1000 00:35:53,840 --> 00:35:55,040 A VARIETY OF WHAT INDIVIDUALS 1001 00:35:55,040 --> 00:35:56,680 MIGHT DO AND A LOT OF WHAT WE 1002 00:35:56,680 --> 00:35:58,200 HAVE IN THIS BOX CAME FROM THAT 1003 00:35:58,200 --> 00:36:00,840 HEAD MODEL IN WHICH THEY DID A 1004 00:36:00,840 --> 00:36:02,160 QUALITATIVE INTERVIEW WITH 1005 00:36:02,160 --> 00:36:03,000 CANCER SURVIVORS. 1006 00:36:03,000 --> 00:36:04,440 SO WHILE YOU HAD THIS ECONOMIC 1007 00:36:04,440 --> 00:36:05,600 BURDEN OF DISEASE, YOU MIGHT 1008 00:36:05,600 --> 00:36:06,840 ALSO STILL BE VERY GRATEFUL FOR 1009 00:36:06,840 --> 00:36:07,800 ALL THE OTHER THINGS YOU MAY 1010 00:36:07,800 --> 00:36:10,240 HAVE IN YOUR LIFE. 1011 00:36:10,240 --> 00:36:12,440 SO YOU RELY ON YOUR PERSONAL 1012 00:36:12,440 --> 00:36:12,960 STRENGTHS. 1013 00:36:12,960 --> 00:36:14,400 DECIDE TO BE DETERMINED SO YOU 1014 00:36:14,400 --> 00:36:15,720 FIGHT BACK. 1015 00:36:15,720 --> 00:36:17,480 OR YOU MAY BE FRUSTRATED. 1016 00:36:17,480 --> 00:36:23,320 YOU MAY TAKE CARE OF -- RELYING 1017 00:36:23,320 --> 00:36:24,920 ON YOUR RELIGION OR SPIRITUAL 1018 00:36:24,920 --> 00:36:26,920 BELIEFS, YOU MAY SEEK OUT 1019 00:36:26,920 --> 00:36:27,880 ACCESSING SOCIAL SUPPORT. 1020 00:36:27,880 --> 00:36:30,160 YOU MAY ALSO ENGAGE IN 1021 00:36:30,160 --> 00:36:31,200 PROBLEM-FOCUSED COPING, SO HOW 1022 00:36:31,200 --> 00:36:34,960 AM I GOING TO COPE OR DEAL WITH 1023 00:36:34,960 --> 00:36:37,920 THIS PROBLEM OF THIS BILL I 1024 00:36:37,920 --> 00:36:39,240 DIDN'T EXPECT TO RECEIVE? 1025 00:36:39,240 --> 00:36:41,440 YOU MAY BEGIN TO MAKE CHANGES OR 1026 00:36:41,440 --> 00:36:43,040 SACRIFICES SO YOU MAY DELAY OR 1027 00:36:43,040 --> 00:36:44,720 FOREGO CARE. 1028 00:36:44,720 --> 00:36:47,240 YOU MAY PUT OFF RETIREMENT, YOU 1029 00:36:47,240 --> 00:36:51,200 MAY MAKE FINANCIAL ADJUSTMENTS, 1030 00:36:51,200 --> 00:36:56,240 USING UP SAVINGS, -- MAY SEEK OR 1031 00:36:56,240 --> 00:36:58,520 ACCESSORY SOURCES JUST AS THOSE 1032 00:36:58,520 --> 00:36:59,560 FINANCIAL ASSISTANCE IN DEALING 1033 00:36:59,560 --> 00:36:59,960 WITH INSURANCE. 1034 00:36:59,960 --> 00:37:01,720 SO WE ARE CURIOUS AND WE WILL 1035 00:37:01,720 --> 00:37:03,240 STUDY AND EXPLORE HOPEFULLY WITH 1036 00:37:03,240 --> 00:37:08,280 OUR PILOT PROGRAM WHAT TYPES OF 1037 00:37:08,280 --> 00:37:09,800 SECONDARY APPRAISALS AND COPING 1038 00:37:09,800 --> 00:37:11,520 DO INDIVIDUALS ENGAGE IN, AND 1039 00:37:11,520 --> 00:37:17,440 HOW MIGHT THAT COPING LEAD TO 1040 00:37:17,440 --> 00:37:19,040 EMOTIONAL WELL-BEING, AND HOW 1041 00:37:19,040 --> 00:37:20,120 DOES EMOTIONAL WELL-BEING, 1042 00:37:20,120 --> 00:37:22,640 IMPORTANTLY, LEAD TO QUALITY OF 1043 00:37:22,640 --> 00:37:23,640 LIFE AND HEALTH OUTCOMES? 1044 00:37:23,640 --> 00:37:28,960 WHAT ARE THE UNDERLYING 1045 00:37:28,960 --> 00:37:30,160 PSYCHOSOCIAL PATTERNS. 1046 00:37:30,160 --> 00:37:31,600 SO WORK IS BEGINNING TO BE DONE 1047 00:37:31,600 --> 00:37:33,680 IN THIS AREA, AND I WANTED TO 1048 00:37:33,680 --> 00:37:38,960 SHARE THIS PAIM WITH YOU THAT 1049 00:37:38,960 --> 00:37:40,120 EXAMINED THE RACIAL DIFFERENCES 1050 00:37:40,120 --> 00:37:48,640 IN EMPLOYMENT AND COST 1051 00:37:48,640 --> 00:37:49,520 MANAGEMENT BEHAVIORS IN PATIENTS 1052 00:37:49,520 --> 00:37:51,200 WITH METASTATIC BREAST CANCER. 1053 00:37:51,200 --> 00:37:52,920 SO IN THIS STUDY, THEY HAD A 1054 00:37:52,920 --> 00:37:54,040 DIVERSE SAMPLE OF WOMEN WITH 1055 00:37:54,040 --> 00:37:54,680 BREAST CANCER. 1056 00:37:54,680 --> 00:37:56,680 THEY COMPLETED AN ONLINE SURVEY, 1057 00:37:56,680 --> 00:37:59,080 ALL HAD METASTATIC BREAST 1058 00:37:59,080 --> 00:37:59,280 CANCER. 1059 00:37:59,280 --> 00:38:00,480 AND THIS GRAPH SHOWS SOME OF 1060 00:38:00,480 --> 00:38:02,760 THEIR CHANGES IN WORK FOR PAY BY 1061 00:38:02,760 --> 00:38:04,640 RACE AND ETHNICITY. 1062 00:38:04,640 --> 00:38:07,280 THE FIRST BAR, THE WHITE, 1063 00:38:07,280 --> 00:38:08,480 REFLECTS THE NON-HISPANIC 1064 00:38:08,480 --> 00:38:09,760 WHITES. 1065 00:38:09,760 --> 00:38:11,520 THE SECOND BAR, NON-HISPANIC 1066 00:38:11,520 --> 00:38:14,160 BLACKS, THE THIRD BAR, 1067 00:38:14,160 --> 00:38:15,800 HISPANICS, THE FOURTH, ASIAN 1068 00:38:15,800 --> 00:38:18,320 PACIFIC ISLANDERS, AND THE LAST, 1069 00:38:18,320 --> 00:38:19,280 AMERICAN INDIANS. 1070 00:38:19,280 --> 00:38:23,680 AND AS YOU CAN SEE, THERE'S 1071 00:38:23,680 --> 00:38:25,320 GREAT DIVERSITY WITH RESPECT TO 1072 00:38:25,320 --> 00:38:27,960 THE CHANGES IN WORK, BOTH IN 1073 00:38:27,960 --> 00:38:29,480 TERMS OF WHAT INDIVIDUALS HAD TO 1074 00:38:29,480 --> 00:38:32,760 DO, STOPPED WORKING, REDUCE 1075 00:38:32,760 --> 00:38:34,440 HOURS, TOOK PAID LEAVE, TOOK 1076 00:38:34,440 --> 00:38:36,840 UNPAID LEAVE, RETIRED, OR 1077 00:38:36,840 --> 00:38:43,600 CHANGED JOBS. 1078 00:38:43,600 --> 00:38:45,360 THE NEXT SLIDE SPEAKS TO THE 1079 00:38:45,360 --> 00:38:49,080 COST MANAGEMENT BEHAVIORS BY 1080 00:38:49,080 --> 00:38:52,240 RACE. 1081 00:38:52,240 --> 00:38:54,000 AS YOU CAN SEE, AGAIN THERE'S 1082 00:38:54,000 --> 00:38:54,800 GREAT VARIABILITY TO WHAT 1083 00:38:54,800 --> 00:38:56,200 INDIVIDUALS WERE DOING. 1084 00:38:56,200 --> 00:39:00,480 STIPPING SKIPPING OR REFUSIN, 1085 00:39:00,480 --> 00:39:02,240 USE SAVINGS, FILE FOR 1086 00:39:02,240 --> 00:39:03,520 DISABILITY, SKIPPED OVER MEDICAL 1087 00:39:03,520 --> 00:39:04,960 BILLS, SKIPPED NON-MEDICAL 1088 00:39:04,960 --> 00:39:09,680 BILLS, APPLIED FOR FINANCIAL 1089 00:39:09,680 --> 00:39:11,520 ASSISTANCE, RECEIVED FINANCIAL 1090 00:39:11,520 --> 00:39:12,720 ASSISTANCE. 1091 00:39:12,720 --> 00:39:14,280 >> YOU HAVE ABOUT FIVE MINUTES, 1092 00:39:14,280 --> 00:39:14,520 MICHELLE. 1093 00:39:14,520 --> 00:39:15,200 THANK YOU. 1094 00:39:15,200 --> 00:39:15,800 >> THANK YOU. 1095 00:39:15,800 --> 00:39:17,360 AND AS YOU CAN SEE, WHEN YOU 1096 00:39:17,360 --> 00:39:18,760 THINK ABOUT INDIVIDUALS HAVING 1097 00:39:18,760 --> 00:39:20,840 TO ENGAGE IN ALL OF THESE 1098 00:39:20,840 --> 00:39:23,520 DIFFERENT BEHAVIORS, WHAT IMPACT 1099 00:39:23,520 --> 00:39:27,800 MIGHT THAT HAVE ON ONE'S 1100 00:39:27,800 --> 00:39:28,560 EMOTIONAL WELL-BEING? 1101 00:39:28,560 --> 00:39:29,800 THESE DATA I'M PRESENTING YOU 1102 00:39:29,800 --> 00:39:32,040 NOW ARE UNADJUSTED ODDS. 1103 00:39:32,040 --> 00:39:34,360 WHEN THEY DID ADJUST FOR 1104 00:39:34,360 --> 00:39:36,480 SOCIODEMOGRAPHIC AND CLINICAL 1105 00:39:36,480 --> 00:39:38,080 FACTORS, THEY DID CONTINUE TO 1106 00:39:38,080 --> 00:39:39,160 FIND RACIAL AND ETHNIC 1107 00:39:39,160 --> 00:39:39,840 DIFFERENCES. 1108 00:39:39,840 --> 00:39:42,560 SO FOR EXAMPLE, NON-HISPANIC 1109 00:39:42,560 --> 00:39:43,920 BLACKS AN ASIAN PACIFIC 1110 00:39:43,920 --> 00:39:45,200 ISLANDERS WHEN COMPARED TO 1111 00:39:45,200 --> 00:39:46,840 WHITES WERE MORE LIKELY TO 1112 00:39:46,840 --> 00:39:48,720 REFUSE TREATMENT OR STOP 1113 00:39:48,720 --> 00:39:49,680 TREATMENT. 1114 00:39:49,680 --> 00:39:52,760 AS A RESULT OF THE COST 1115 00:39:52,760 --> 00:39:53,960 ASSOCIATED WITH THEIR CANCER 1116 00:39:53,960 --> 00:39:57,000 TREATMENT. 1117 00:39:57,000 --> 00:39:59,760 SO THAT'S JUST A QUICK 1118 00:39:59,760 --> 00:40:00,960 INTRODUCTION TO THE EMOT-ECON 1119 00:40:00,960 --> 00:40:02,040 RESEARCH NETWORK. 1120 00:40:02,040 --> 00:40:03,360 WE HOPE YOU WILL JOIN US ON THIS 1121 00:40:03,360 --> 00:40:03,840 JOURNEY. 1122 00:40:03,840 --> 00:40:10,480 WE HAVE A TWITTER HANDLE AT EMO 1123 00:40:10,480 --> 00:40:11,480 UNDERSCORE ECON. 1124 00:40:11,480 --> 00:40:13,680 WE ALSO HAVE A WEBPAGE AND WE 1125 00:40:13,680 --> 00:40:15,280 HOPE YOU JOIN EMOT-ECON. 1126 00:40:15,280 --> 00:40:16,840 JOINING EMOT-ECON MAKES YOU 1127 00:40:16,840 --> 00:40:18,200 ELIGIBLE FOR THE PILOT PROJECTS 1128 00:40:18,200 --> 00:40:21,880 AND YOU ALSO HAVE ACCESS TO OUR 1129 00:40:21,880 --> 00:40:24,200 ARCHIVED SEMINARS THAT WE ARE 1130 00:40:24,200 --> 00:40:24,480 RECORDING. 1131 00:40:24,480 --> 00:40:27,040 SO AS I PROMISED TO CONCLUDE 1132 00:40:27,040 --> 00:40:30,600 WITH SOME REFLECTIONS, WHEN I 1133 00:40:30,600 --> 00:40:31,760 THINK ABOUT PATIENTS WITH A 1134 00:40:31,760 --> 00:40:33,240 HISTORY OF CANCER AND I THINK 1135 00:40:33,240 --> 00:40:35,640 ABOUT THIS PRESENTATION, I'M 1136 00:40:35,640 --> 00:40:36,560 REMINDED OF THE IMPORTANCE OF 1137 00:40:36,560 --> 00:40:37,960 CONSIDERING THE WHOLE PERSON. 1138 00:40:37,960 --> 00:40:38,720 ALWAYS GOING BACK TO THAT 1139 00:40:38,720 --> 00:40:40,480 QUALITY OF LIFE MODEL IN WHICH 1140 00:40:40,480 --> 00:40:42,880 WELL-BEING REALLY IS ACROSS 1141 00:40:42,880 --> 00:40:43,760 MULTIPLE DOMAINS. 1142 00:40:43,760 --> 00:40:45,160 AND WHEN YOU THINK ABOUT THE 1143 00:40:45,160 --> 00:40:47,680 WHOLE PERSON, YOU ALWAYS WANT TO 1144 00:40:47,680 --> 00:40:50,000 KNOW OR THINK ABOUT OR CONSIDER 1145 00:40:50,000 --> 00:40:51,320 WHAT ROLE DO HEALTHCARE 1146 00:40:51,320 --> 00:40:52,320 PROVERS PLAY, DO 1147 00:40:52,320 --> 00:40:55,000 POLICY MAKERS PLAY, AND HOW CAN 1148 00:40:55,000 --> 00:40:56,440 WE ALL COME TOGETHER TO ADDRESS 1149 00:40:56,440 --> 00:40:58,320 THE NEEDS OF SURVIVORS? 1150 00:40:58,320 --> 00:41:04,360 SO FOR EXAMPLE, A PROJECT BY DRD 1151 00:41:04,360 --> 00:41:08,000 WITH PATIENTS AS WELL AS CANCER 1152 00:41:08,000 --> 00:41:08,960 CENTER STAFF TO TALK ABOUT THE 1153 00:41:08,960 --> 00:41:10,360 COST OF CARE CONVERSATIONS. 1154 00:41:10,360 --> 00:41:12,240 AND PATIENTS ACTUALLY WANT TO 1155 00:41:12,240 --> 00:41:13,840 TALK ABOUT COST BUT THEY WANT TO 1156 00:41:13,840 --> 00:41:17,280 DO SO AT A CERTAIN TIME, NOT AS 1157 00:41:17,280 --> 00:41:19,040 SOON AS THEY GET DIAGNOSED, BUT 1158 00:41:19,040 --> 00:41:21,000 BEFORE TREATMENT BEGINS AND THEY 1159 00:41:21,000 --> 00:41:22,920 WANT THAT INDIVIDUAL HAVING THAT 1160 00:41:22,920 --> 00:41:24,640 CONVERSATION WITH THEM TO BE 1161 00:41:24,640 --> 00:41:25,320 COMPASSIONATE AND CARING. 1162 00:41:25,320 --> 00:41:26,800 SO WHEN YOU THINK ABOUT AN 1163 00:41:26,800 --> 00:41:28,920 INTERVENTION SUCH AS LIKE HOW WE 1164 00:41:28,920 --> 00:41:30,200 STRUCTURE THOSE COST 1165 00:41:30,200 --> 00:41:30,840 CONVERSATION, ONE CAN SEE THAT 1166 00:41:30,840 --> 00:41:32,360 IT PROBABLY HAS A ROLE AND CAN 1167 00:41:32,360 --> 00:41:34,760 IMPACT ONE'S EMOTIONAL HEALTH AS 1168 00:41:34,760 --> 00:41:35,720 THEY GO THROUGH THE JOURNEY. 1169 00:41:35,720 --> 00:41:37,120 HOW DO WE DEVELOP INTERVENTIONS 1170 00:41:37,120 --> 00:41:38,320 THAT HONOR THE WHOLE PERSON? 1171 00:41:38,320 --> 00:41:40,520 I THINK THIS IS ONE OF THE HARD 1172 00:41:40,520 --> 00:41:40,840 ONES. 1173 00:41:40,840 --> 00:41:43,040 I THINK AS RESEARCHER, WE STUDY 1174 00:41:43,040 --> 00:41:45,640 DIFFERENT PARTS OF THE PUZZLE. 1175 00:41:45,640 --> 00:41:47,440 THE PATIENTS REALLY ARE WHOLE 1176 00:41:47,440 --> 00:41:48,960 PEOPLE AND THEY ACTUALLY WANT A 1177 00:41:48,960 --> 00:41:50,480 MORE HOLISTIC, WHOLE APPROACH TO 1178 00:41:50,480 --> 00:41:53,440 OUR WORK. 1179 00:41:53,440 --> 00:41:54,560 WHAT DOES WELL-BEING REALLY 1180 00:41:54,560 --> 00:41:54,880 MEAN? 1181 00:41:54,880 --> 00:41:56,440 IS IT WELL-BEING WITH THE NEW 1182 00:41:56,440 --> 00:41:56,920 NORMAL? 1183 00:41:56,920 --> 00:42:00,480 THAT TERM IS OFTEN USED WITH 1184 00:42:00,480 --> 00:42:01,720 CANCER SURVIVORS THAT THIS IS 1185 00:42:01,720 --> 00:42:03,000 THE NEW NORMAL, SO WHAT DOES 1186 00:42:03,000 --> 00:42:04,080 THAT MEAN UNDER THOSE 1187 00:42:04,080 --> 00:42:04,960 CIRCUMSTANCES TO BE WELL? 1188 00:42:04,960 --> 00:42:07,280 AND AS WE ADVANCE THE SCIENCE OF 1189 00:42:07,280 --> 00:42:08,520 EMOTIONAL WELL-BEING, DHOW WE 1190 00:42:08,520 --> 00:42:12,760 DETERMINE WHAT IS A E 1191 00:42:12,760 --> 00:42:13,760 DETERMINE WHAT IS A HEALTHY 1192 00:42:13,760 --> 00:42:14,920 LEVEL OF EMOTIONAL WELL-BEING? 1193 00:42:14,920 --> 00:42:16,520 I HAVE MANY ACKNOWLEDGMENTS THAT 1194 00:42:16,520 --> 00:42:18,120 I WOULD LIKE TO ACKNOWLEDGE AND 1195 00:42:18,120 --> 00:42:20,520 THANK, SO THANK YOU FOR THE 1196 00:42:20,520 --> 00:42:23,040 OPPORTUNITY TO BE A PART OF THE 1197 00:42:23,040 --> 00:42:25,000 SPRING 2022 SEASON OF 1198 00:42:25,000 --> 00:42:26,440 INTEGRATIVE MEDICINE RESEARCH 1199 00:42:26,440 --> 00:42:28,200 LECTURE SERIES. 1200 00:42:28,200 --> 00:42:30,160 I'D LIKE TO ACKNOWLEDGE AND 1201 00:42:30,160 --> 00:42:31,480 THANK PARTICIPANTS OF RESEARCH 1202 00:42:31,480 --> 00:42:33,120 STUDIES WHO INVITED US INTO 1203 00:42:33,120 --> 00:42:34,880 THEIR LIVES IN ORDER TO BE ABLE 1204 00:42:34,880 --> 00:42:36,160 TO ASK QUESTIONS AND UNDERSTAND 1205 00:42:36,160 --> 00:42:37,120 THEIR EXPERIENCES AND HOPEFULLY 1206 00:42:37,120 --> 00:42:38,480 COME UP WITH INTERVENTIONS AND 1207 00:42:38,480 --> 00:42:40,320 PROGRAMS TO ELEVATE THE HEALTH 1208 00:42:40,320 --> 00:42:42,360 AND WELL-BEING OF EVERYONE. 1209 00:42:42,360 --> 00:42:44,320 I'D LIKE TO THANK THE PRINCIPAL 1210 00:42:44,320 --> 00:42:45,480 INVESTIGATORS OF THE ONGOING 1211 00:42:45,480 --> 00:42:46,600 STUDYS THAT ALLOWED ME TO 1212 00:42:46,600 --> 00:42:48,640 HIGHLIGHT THEIR STUDY IN MY 1213 00:42:48,640 --> 00:42:50,200 PRESENTATION TODAY, PROVIDED 1214 00:42:50,200 --> 00:42:54,000 CONTENT FOR THOSE SLIDES. 1215 00:42:54,000 --> 00:42:56,880 I'D ALSO LIKE TO ACKNOWLEDGE THE 1216 00:42:56,880 --> 00:43:02,440 EMOT-ECON TEAM, DR. MARIA PISU, 1217 00:43:02,440 --> 00:43:03,760 KOAS INVESTIGATORS, STEERING 1218 00:43:03,760 --> 00:43:07,720 COMMITTEE MEMBERS AND PROGRAM 1219 00:43:07,720 --> 00:43:08,440 OFFICIAL NETWORK. 1220 00:43:08,440 --> 00:43:13,280 AND I WELCOME ANY QUESTIONS. 1221 00:43:13,280 --> 00:43:14,440 THANK YOU FOR YOUR ATTENTION 1222 00:43:14,440 --> 00:43:15,800 TODAY. 1223 00:43:15,800 --> 00:43:17,320 >> WELL, THANK YOU, DR. MARTIN. 1224 00:43:17,320 --> 00:43:19,600 THAT WAS REALLY AN INTERESTING 1225 00:43:19,600 --> 00:43:21,240 TALK, AND IT'S FASCINATING TO 1226 00:43:21,240 --> 00:43:23,800 SEE HOW YOU'RE LAUNCHING THIS 1227 00:43:23,800 --> 00:43:25,840 NETWORK AND THE PILOT PROGRAMS. 1228 00:43:25,840 --> 00:43:27,920 WE'RE GOING TO MOVE NOW TO OUR Q 1229 00:43:27,920 --> 00:43:29,160 & A SESSION. 1230 00:43:29,160 --> 00:43:31,880 AND I ENCOURAGE ANY VIEWERS WHO 1231 00:43:31,880 --> 00:43:35,480 ARE WATCHING ON VIDEOCAST OR ON 1232 00:43:35,480 --> 00:43:36,400 FACEBOOK LIVE TO SHARE YOUR 1233 00:43:36,400 --> 00:43:37,040 QUESTIONS WITH US. 1234 00:43:37,040 --> 00:43:38,680 YOU CAN EITHER USE THE NIH 1235 00:43:38,680 --> 00:43:40,880 VIDEOCAST FEEDBACK FORM OR PUT 1236 00:43:40,880 --> 00:43:43,800 ANY COMMENTS YOU HAVE INTO THE 1237 00:43:43,800 --> 00:43:44,680 FACEBOOK LIVE, YOU CAN POST A 1238 00:43:44,680 --> 00:43:47,680 COMMENT THERE OR QUESTION. 1239 00:43:47,680 --> 00:43:49,160 SO DR. SHURTLEFF, I'M GOING TO 1240 00:43:49,160 --> 00:43:50,960 TURN TO YOU TO KICK OFF THIS Q & 1241 00:43:50,960 --> 00:43:51,360 A SESSION. 1242 00:43:51,360 --> 00:43:52,800 ARE THERE ANY QUESTIONS YOU WANT 1243 00:43:52,800 --> 00:43:57,360 TO BEGIN WITH FOR DR. MARTIN? 1244 00:43:57,360 --> 00:43:59,240 >> DR. MARTIN, THAT WAS A GREAT 1245 00:43:59,240 --> 00:43:59,480 TALK. 1246 00:43:59,480 --> 00:44:00,640 THANK YOU SO MUCH FOR 1247 00:44:00,640 --> 00:44:01,640 PRESENTING. 1248 00:44:01,640 --> 00:44:02,680 IT'S SUCH IMPORTANT WORK WHEN 1249 00:44:02,680 --> 00:44:04,480 YOU THINK ABOUT CANCER SURVIVORS 1250 00:44:04,480 --> 00:44:06,040 AND THE STRESS THEY FACE, AND I 1251 00:44:06,040 --> 00:44:07,080 REALLY APPRECIATED THE 1252 00:44:07,080 --> 00:44:07,800 TESTIMONIAL FROM MARK AS A 1253 00:44:07,800 --> 00:44:08,960 PATIENT SHOWING REALLY WHAT IT'S 1254 00:44:08,960 --> 00:44:14,120 LIKE TO GO THROUGH SUCH AN 1255 00:44:14,120 --> 00:44:14,440 ORDEAL. 1256 00:44:14,440 --> 00:44:15,520 I WAS CURIOUS, I APPRECIATE THE 1257 00:44:15,520 --> 00:44:16,640 IDEA OF THIS COPING STRATEGY, I 1258 00:44:16,640 --> 00:44:17,880 THINK IT'S SO IMPORTANT AND 1259 00:44:17,880 --> 00:44:19,280 YOU'VE BROUGHT IT UP SO 1260 00:44:19,280 --> 00:44:19,720 ELOQUENTLY. 1261 00:44:19,720 --> 00:44:21,120 I'M WONDERING, THOUGH, WHEN I 1262 00:44:21,120 --> 00:44:25,200 THINK ABOUT RESILIENCE AND IN 1263 00:44:25,200 --> 00:44:26,440 THAT CONTEXT OF RESILIENCE, THE 1264 00:44:26,440 --> 00:44:28,160 IDEA OF RESISTING A CHALLENGE, 1265 00:44:28,160 --> 00:44:32,000 SO MAYBE PREPARING INDIVIDUALS 1266 00:44:32,000 --> 00:44:34,920 PRIOR TO A SIGNIFICANT LIFE 1267 00:44:34,920 --> 00:44:37,000 EVENT LIKE CANCER, ARE THERE 1268 00:44:37,000 --> 00:44:37,880 THINGS YOU CAN THINK ABOUT 1269 00:44:37,880 --> 00:44:39,560 BEFORE AN INDIVIDUAL FACES A 1270 00:44:39,560 --> 00:44:42,920 MAJOR LIFE EVENT LIKE CANCER, 1271 00:44:42,920 --> 00:44:46,520 WAYS OF STRENGTHENING 1272 00:44:46,520 --> 00:44:49,480 RESILIENCE, WAY OF CONCEPTIZING 1273 00:44:49,480 --> 00:44:51,000 OR THINKING ABOUT STRATEGIES 1274 00:44:51,000 --> 00:44:56,600 THAT THEY MIGHT USE OR BE 1275 00:44:56,600 --> 00:45:00,880 KNOWLEDGEABLE ABOUT PRIOR TO THE 1276 00:45:00,880 --> 00:45:02,400 SORT OF EVENTS WE CAN SORT OF 1277 00:45:02,400 --> 00:45:03,360 PREPARE THEM FOR? 1278 00:45:03,360 --> 00:45:06,440 HAVE YOU THOUGHT ABOUT THAT? 1279 00:45:06,440 --> 00:45:07,760 CERTAINLY AS THEY GET INTO THESE 1280 00:45:07,760 --> 00:45:08,960 SITUATIONS, THEY NEED TO COPE, 1281 00:45:08,960 --> 00:45:10,840 BUT ARE THERE OTHER WAYS WE 1282 00:45:10,840 --> 00:45:12,800 COULD MAYBE INTERVENE SOONER, 1283 00:45:12,800 --> 00:45:15,760 EITHER SYSTEMICALLY THROUGH 1284 00:45:15,760 --> 00:45:18,920 STRUCTURALNG 1285 00:45:18,920 --> 00:45:20,120 ENVIRONMENTAL, EDUCATIONAL 1286 00:45:20,120 --> 00:45:22,520 INTERVENTIONS OR OTHER WAYS WE 1287 00:45:22,520 --> 00:45:25,160 MIGHT DO SOMETHING PRIOR TO THE 1288 00:45:25,160 --> 00:45:26,560 STRESSFUL EVENT? 1289 00:45:26,560 --> 00:45:29,160 JUST A THOUGHT. 1290 00:45:29,160 --> 00:45:30,000 >> THANK YOU FOR THAT QUESTION. 1291 00:45:30,000 --> 00:45:31,000 THAT'S A GREAT QUESTION AND ONE 1292 00:45:31,000 --> 00:45:32,480 THAT I HAD NOT REALLY THOUGHT. 1293 00:45:32,480 --> 00:45:35,680 SO IT'S REALLY AN INTERESTING 1294 00:45:35,680 --> 00:45:37,800 WAY OF KIND OF CONCEPTUALIZING 1295 00:45:37,800 --> 00:45:41,040 HOW WE MIGHT SUPPORT PATIENTS 1296 00:45:41,040 --> 00:45:42,480 BETTER BY PREPARING THEM PRIOR 1297 00:45:42,480 --> 00:45:44,800 TO THE EVENT HAPPENING. 1298 00:45:44,800 --> 00:45:46,720 SO I WOULD HAVE TO GIVE THAT A 1299 00:45:46,720 --> 00:45:51,000 LOT OF THOUGHT, AND THERE ARE A 1300 00:45:51,000 --> 00:45:52,320 COUPLE THINGS I'M KIND OF 1301 00:45:52,320 --> 00:45:53,960 STRUGGLING IN MY MIND RIGHT NOW 1302 00:45:53,960 --> 00:45:55,160 AS I THINK ABOUT IT. 1303 00:45:55,160 --> 00:45:56,760 SO WHEN I THINK ABOUT IT FROM A 1304 00:45:56,760 --> 00:45:58,240 HEALTH BEHAVIOR PERSPECTIVE, I 1305 00:45:58,240 --> 00:45:59,120 THINK ONE OF THE THINGS WE'VE 1306 00:45:59,120 --> 00:46:00,760 TRIED DO IS, YOU KNOW, LET'S SAY 1307 00:46:00,760 --> 00:46:04,160 ENCOURAGE PHYSICAL ACTIVITY OR 1308 00:46:04,160 --> 00:46:05,120 HEALTHY EATING FOR SOME EVENT 1309 00:46:05,120 --> 00:46:07,400 THAT IS SO DISTAL. 1310 00:46:07,400 --> 00:46:11,800 AND I THINK THAT WE'RE LEARNING 1311 00:46:11,800 --> 00:46:13,120 THAT WE NEED TO BE ABLE TO 1312 00:46:13,120 --> 00:46:14,080 CONNECT TO SOMETHING THAT IS 1313 00:46:14,080 --> 00:46:15,760 SORT OF MORE IN THE HERE AND NO 1314 00:46:15,760 --> 00:46:18,040 TO REALLY MOTIVATE INDIVIDUALS 1315 00:46:18,040 --> 00:46:20,800 TO MAKE THOSE CHANGES. 1316 00:46:20,800 --> 00:46:23,120 SO SIMILARLY, I WONDER HOW WE 1317 00:46:23,120 --> 00:46:25,040 MIGHT CRAFT -- LET'S BE 1318 00:46:25,040 --> 00:46:25,800 RESILIENT FOR SOMETHING THAT MAY 1319 00:46:25,800 --> 00:46:28,200 HAPPEN IN THE FUTURE, SO I'M NOT 1320 00:46:28,200 --> 00:46:29,200 EXACTLY SURE, BUT THERE'S GOING 1321 00:46:29,200 --> 00:46:30,080 TO GIVE ME SOMETHING TO THINK 1322 00:46:30,080 --> 00:46:32,520 ABOUT THIS AFTERNOON FOR SURE. 1323 00:46:32,520 --> 00:46:34,560 I MEAN, THAT'S REALLY 1324 00:46:34,560 --> 00:46:34,880 INTERESTING. 1325 00:46:34,880 --> 00:46:38,640 BUT I THINK THE OTHER THING I 1326 00:46:38,640 --> 00:46:41,800 THINK ABOUT AS A PSYCHOLOGIST IS 1327 00:46:41,800 --> 00:46:42,880 LIKE, YOU WANT THAT HEALTHY 1328 00:46:42,880 --> 00:46:45,200 COPING BUT WE ALSO WANT 1329 00:46:45,200 --> 00:46:46,280 INDIVIDUALS TO EXPERIENCE THE 1330 00:46:46,280 --> 00:46:50,120 FULL RANGE OF EMOTIONS. 1331 00:46:50,120 --> 00:46:51,880 I THINK THAT'S ONE OF THE THINGS 1332 00:46:51,880 --> 00:46:53,400 WE'VE STRUGGLED WITH WHEN WE 1333 00:46:53,400 --> 00:46:55,800 THINK ABOUT EMOTIONAL 1334 00:46:55,800 --> 00:46:58,000 WELL-BEING, WHEN SOMETHING SAD 1335 00:46:58,000 --> 00:46:59,320 HAPPEN, YOU TRULY WANT THEM TO 1336 00:46:59,320 --> 00:47:00,520 EXPERIENCE THAT GRIEF AND THAT 1337 00:47:00,520 --> 00:47:04,240 SADNESS AND THAT SORT OF AN 1338 00:47:04,240 --> 00:47:05,240 APPROPRIATE EMOTION DURING THAT 1339 00:47:05,240 --> 00:47:07,080 TIME. 1340 00:47:07,080 --> 00:47:09,280 AND SO HOW DO WE BALANCE HELPING 1341 00:47:09,280 --> 00:47:11,680 INDIVIDUALS EXPERIENCE FULLY BUT 1342 00:47:11,680 --> 00:47:12,880 MAYBE NOT STAYING IN THAT SPACE 1343 00:47:12,880 --> 00:47:16,000 SO LONG THAT IT MAYBE DISRUPTS 1344 00:47:16,000 --> 00:47:19,040 OTHER AREAS OF THEIR LIFE. 1345 00:47:19,040 --> 00:47:19,800 SO IT'S INTERESTING WHEN YOU 1346 00:47:19,800 --> 00:47:23,080 THINK ABOUT RESILIENCE AND WHAT 1347 00:47:23,080 --> 00:47:24,760 THAT MEANS, WHAT THAT MEANS IN 1348 00:47:24,760 --> 00:47:27,800 DIFFERENT CONTEXTS. 1349 00:47:27,800 --> 00:47:29,040 THANK YOU FOR THAT QUESTION. 1350 00:47:29,040 --> 00:47:30,320 >> DO YOU HAVE ANY OTHER 1351 00:47:30,320 --> 00:47:31,920 QUESTIONS, DAVID, OR WE CAN MOVE 1352 00:47:31,920 --> 00:47:33,280 TO A QUESTION FROM OUR AUDIENCE. 1353 00:47:33,280 --> 00:47:36,680 >> PLEASE GO AHEAD. 1354 00:47:36,680 --> 00:47:39,360 >> ONE OF OUR AUDIENCE MEMBERS 1355 00:47:39,360 --> 00:47:41,160 ASKS DR. MARTIN FOR YOUR 1356 00:47:41,160 --> 00:47:44,000 RESEARCH, DID YOU HAVE AN 1357 00:47:44,000 --> 00:47:45,840 OPERATIONAL DEFINITION OF 1358 00:47:45,840 --> 00:47:48,800 SPIRITUALITY OR SPIRITUAL 1359 00:47:48,800 --> 00:47:49,160 HEALTH? 1360 00:47:49,160 --> 00:47:50,120 AND I KNOW YOU TALKED A LITTLE 1361 00:47:50,120 --> 00:47:51,520 BIT ABOUT DEFINITIONS, SO I 1362 00:47:51,520 --> 00:47:53,160 THINK THIS IS SOMEBODY WANTING 1363 00:47:53,160 --> 00:47:56,920 TO FOCUS IN ON SPIRITUALITY AND 1364 00:47:56,920 --> 00:47:58,240 SPIRITUAL HEALTH ITSELF. 1365 00:47:58,240 --> 00:47:59,000 ANY THOUGHTS YOU CAN SHARE? 1366 00:47:59,000 --> 00:48:02,600 >> SO I DID NOT HAVE A 1367 00:48:02,600 --> 00:48:05,760 DEFINITION FOR SPIRITUALITY, AND 1368 00:48:05,760 --> 00:48:11,000 I MIGHT MAYBE CONNECT THE 1369 00:48:11,000 --> 00:48:12,320 INDIVIDUALS THAT I KNOW SPEND 1370 00:48:12,320 --> 00:48:13,400 MORE OF THEIR TIME IN THAT AREA 1371 00:48:13,400 --> 00:48:14,600 OF RESEARCH, BUT IT'S VERY 1372 00:48:14,600 --> 00:48:15,760 IMPORTANT AS WE MOVE FORWARD, WE 1373 00:48:15,760 --> 00:48:17,160 ALWAYS NEED TO HAVE THOSE VERY 1374 00:48:17,160 --> 00:48:18,240 CLEAR DEFINITIONS AND I WOULD 1375 00:48:18,240 --> 00:48:21,560 LOVE TO LEARN FROM THAT AUDIENCE 1376 00:48:21,560 --> 00:48:26,600 MEMBER HOW THEY CONCEPTUALIZE 1377 00:48:26,600 --> 00:48:27,600 SPIRITUALITY. 1378 00:48:27,600 --> 00:48:28,640 BECAUSE I THINK FOR SURE WE NEED 1379 00:48:28,640 --> 00:48:29,880 TO BE CLEAR ABOUT OUR 1380 00:48:29,880 --> 00:48:30,280 DEFINITIONS. 1381 00:48:30,280 --> 00:48:32,160 AND I THINK THERE'S -- IN THE 1382 00:48:32,160 --> 00:48:33,800 FIELD, PEOPLE HAVE BEEN 1383 00:48:33,800 --> 00:48:35,680 CHALLENGED WITH RELIGION VERSUS 1384 00:48:35,680 --> 00:48:39,360 SPIRITUALITY AND WHAT'S THE 1385 00:48:39,360 --> 00:48:41,440 DISTINCTION, AND THOSE ARE 1386 00:48:41,440 --> 00:48:44,800 COLLAR FIXES TO MAKE 1387 00:48:44,800 --> 00:48:45,840 CLARIFICATIONS WE NEED TO MAKE 1388 00:48:45,840 --> 00:48:46,360 FOR SURE. 1389 00:48:46,360 --> 00:48:48,360 >> SO WE HAD A QUESTION FROM A 1390 00:48:48,360 --> 00:48:49,200 COLLEAGUE, ONE OF OUR COLLEAGUES 1391 00:48:49,200 --> 00:48:51,400 SAYS, CAN YOU ELABORATE ON THE 1392 00:48:51,400 --> 00:48:53,240 FINDING FROM YOUR PAPER THAT 1393 00:48:53,240 --> 00:48:56,480 THERE WAS VARIATION ACROSS 1394 00:48:56,480 --> 00:48:59,520 RACIAL/ETHNIC FREUPS AND D 1395 00:48:59,520 --> 00:49:00,840 WORRYING ABOUT MAKING TREATMENT 1396 00:49:00,840 --> 00:49:01,160 DECISIONS. 1397 00:49:01,160 --> 00:49:02,440 SO CAN YOU ELABORATE ON THAT A 1398 00:49:02,440 --> 00:49:02,880 LITTLE BIT? 1399 00:49:02,880 --> 00:49:05,640 >> SURE. 1400 00:49:05,640 --> 00:49:07,920 SO DEPENDING ON THE OUTCOME WE 1401 00:49:07,920 --> 00:49:09,280 WERE THINKING ABOUT, THERE WERE 1402 00:49:09,280 --> 00:49:14,080 THOSE DIFFERENCES BY RACE AND 1403 00:49:14,080 --> 00:49:15,720 ETHNICITY, SO I'M TRYING TO 1404 00:49:15,720 --> 00:49:16,520 REMEMBER BECAUSE THERE WERE 1405 00:49:16,520 --> 00:49:17,520 SEVERAL OUTCOMES FOR THAT IN 1406 00:49:17,520 --> 00:49:20,680 ADDITION TO THE ECONOMIC BURDEN. 1407 00:49:20,680 --> 00:49:26,480 I DO KNOW THAT -- I'M SORRY, CAN 1408 00:49:26,480 --> 00:49:32,200 I GET BACK ON THAT QUESTION? 1409 00:49:32,200 --> 00:49:34,160 >> ABSOLUTELY. 1410 00:49:34,160 --> 00:49:35,320 WE CAN CERTAINLY COME BACK AND 1411 00:49:35,320 --> 00:49:36,880 CIRCLE BACK ON THAT ONE. 1412 00:49:36,880 --> 00:49:40,280 SO WE HAVE A QUESTION HERE FROM 1413 00:49:40,280 --> 00:49:41,880 ONE OF OUR AUDIENCE MEMBERS THAT 1414 00:49:41,880 --> 00:49:43,240 I THINK IS A GOOD ONE AND I 1415 00:49:43,240 --> 00:49:44,200 THINK YOU TOUCHED ON THIS A 1416 00:49:44,200 --> 00:49:44,640 LITTLE BIT. 1417 00:49:44,640 --> 00:49:47,480 AND THIS PERSON IS ASKING, ARE 1418 00:49:47,480 --> 00:49:49,760 PATIENTS AND PATIENT ADVOCATES 1419 00:49:49,760 --> 00:49:51,960 INVOLVED IN THE STUDY DESIGN 1420 00:49:51,960 --> 00:49:55,920 RECRUITMENT AND EVALUATION? 1421 00:49:55,920 --> 00:49:57,320 SO TO WHAT LEVEL DO YOU HAVE 1422 00:49:57,320 --> 00:49:58,960 PATIENT ADVOCATES AND OTHERS 1423 00:49:58,960 --> 00:50:00,320 ENGAGED IN THE STUDY DESIGN? 1424 00:50:00,320 --> 00:50:00,800 >> THANK YOU. 1425 00:50:00,800 --> 00:50:01,800 THAT'S A GREAT QUESTION. 1426 00:50:01,800 --> 00:50:06,240 SO OUR NETWORK IS GUIDED BY 1427 00:50:06,240 --> 00:50:07,640 STEERING COMMITTEE, MEMBERS FROM 1428 00:50:07,640 --> 00:50:08,680 ACROSS THE COUNTRY. 1429 00:50:08,680 --> 00:50:12,200 WE HAVE FOUR INDIVIDUALS WHO ARE 1430 00:50:12,200 --> 00:50:13,280 ACADEMIC RESEARCHERS AND WE HAVE 1431 00:50:13,280 --> 00:50:16,920 FIVE INDIVIDUALS WHO ARE PATIENT 1432 00:50:16,920 --> 00:50:20,640 ADVOCATES, PATIENTS THEMSELVES, 1433 00:50:20,640 --> 00:50:21,440 PROVIDING -- INDIVIDUALS PROVIDE 1434 00:50:21,440 --> 00:50:23,840 CARE IN UNDERSERVED COMMUNITIES. 1435 00:50:23,840 --> 00:50:26,440 AND SO THEREFORE IT'S DEFINITELY 1436 00:50:26,440 --> 00:50:28,280 AT THE TABLE. 1437 00:50:28,280 --> 00:50:30,200 AND WE WOULDN'T DO IT ANY OTHER 1438 00:50:30,200 --> 00:50:31,120 WAY FOR SURE. 1439 00:50:31,120 --> 00:50:32,680 FOR SURE. 1440 00:50:32,680 --> 00:50:35,960 AND THE STEERING COMMITTEE TRULY 1441 00:50:35,960 --> 00:50:37,920 DOES PROVIDE US GUIDANCE ON THE 1442 00:50:37,920 --> 00:50:41,480 PRIORITIES OF THE NETWORK, 1443 00:50:41,480 --> 00:50:42,640 THINKING ABOUT THE PRIORITIES OF 1444 00:50:42,640 --> 00:50:43,760 THE PILOT PROJECTS AND THEY HELP 1445 00:50:43,760 --> 00:50:46,080 US PLAN OUR SCIENTIFIC MEETINGS. 1446 00:50:46,080 --> 00:50:48,000 >> THAT'S GREAT. 1447 00:50:48,000 --> 00:50:49,960 WE'VE HAD A COUPLE OF QUESTIONS 1448 00:50:49,960 --> 00:50:54,440 THAT ARE COMING IN SORT OF ABOUT 1449 00:50:54,440 --> 00:50:58,440 WHAT ERK CYSTS EXISTS IN TE 1450 00:50:58,440 --> 00:50:59,760 FINANCIAL ASSISTANCE TO HELP 1451 00:50:59,760 --> 00:51:00,560 PATIENTS DEAL WITH THE SHORT 1452 00:51:00,560 --> 00:51:04,000 TERM AND LONG TERM ECONOMIC 1453 00:51:04,000 --> 00:51:06,480 BURDENS, EITHER WITH LOCALIZED 1454 00:51:06,480 --> 00:51:08,920 OR ADVANCED STAGE CANCER. 1455 00:51:08,920 --> 00:51:10,800 ARE THERE ANY THINGS THAT PEOPLE 1456 00:51:10,800 --> 00:51:15,040 NEED TO BE AWARE OF THAT ARE 1457 00:51:15,040 --> 00:51:16,040 CONCRETELY AVAILABLE THAT YOU'RE 1458 00:51:16,040 --> 00:51:17,680 AWARE OF THAT YOUR RESEARCH TEAM 1459 00:51:17,680 --> 00:51:18,640 IS AWARE OF? 1460 00:51:18,640 --> 00:51:23,480 >> YES, SO THERE ARE FOUNDATIONS 1461 00:51:23,480 --> 00:51:27,240 OF 1462 00:51:27,240 --> 00:51:28,320 TO HELP INDIVIDUALS NAVIGATE 1463 00:51:28,320 --> 00:51:28,960 THAT JOURNEY. 1464 00:51:28,960 --> 00:51:30,320 I'LL BE HAPPY TO SHARE SOME OF 1465 00:51:30,320 --> 00:51:32,480 THOSE FOUNDATIONS, MAYBE I CAN 1466 00:51:32,480 --> 00:51:34,560 SEND IT AND YOU CAN SHARE IT 1467 00:51:34,560 --> 00:51:35,440 WITH THE INDIVIDUALS THAT HAD 1468 00:51:35,440 --> 00:51:37,240 THE QUESTIONS. 1469 00:51:37,240 --> 00:51:38,880 AS WELL AS CANCER CENTER, A LOT 1470 00:51:38,880 --> 00:51:41,000 OF THEM NOW ARE PILOTING 1471 00:51:41,000 --> 00:51:43,240 FINANCIAL NAVIGATORS TO HELP 1472 00:51:43,240 --> 00:51:44,680 INDIVIDUALS NAVIGATE THAT ASPECT 1473 00:51:44,680 --> 00:51:47,640 OF CARE. 1474 00:51:47,640 --> 00:51:49,160 SO AT CANCER CENTERS, IT'S 1475 00:51:49,160 --> 00:51:50,800 REALLY BEEN A PRIORITY AS WELL, 1476 00:51:50,800 --> 00:51:53,640 SO THERE'S FINANCIAL ASSISTANCE 1477 00:51:53,640 --> 00:51:53,920 NAVIGATORS. 1478 00:51:53,920 --> 00:51:54,640 >> RIGHT. 1479 00:51:54,640 --> 00:51:56,160 RIGHT. 1480 00:51:56,160 --> 00:51:57,480 THAT'S REALLY GOOD TO KNOW. 1481 00:51:57,480 --> 00:52:01,720 AND YES, DEFINITELY WE CAN TOUCH 1482 00:52:01,720 --> 00:52:03,720 BASE AFTERWARD AND GATHER THAT 1483 00:52:03,720 --> 00:52:05,560 INFORMATION TO SHARE WITH THIS 1484 00:52:05,560 --> 00:52:06,360 PARTICULAR AUDIENCE MEMBER WHO 1485 00:52:06,360 --> 00:52:09,160 ASKED THIS QUESTION. 1486 00:52:09,160 --> 00:52:13,600 DAVID, DID YOU HAVE ANY OTHER 1487 00:52:13,600 --> 00:52:14,360 FOLLOW-UP QUESTIONS? 1488 00:52:14,360 --> 00:52:16,280 >> ACTUALLY I HAD ONE OTHER 1489 00:52:16,280 --> 00:52:17,440 THAT'S SORT OF RELATED. 1490 00:52:17,440 --> 00:52:19,040 FINANCIAL BURDEN COMES UP AS AN 1491 00:52:19,040 --> 00:52:19,600 IMPORTANT STRESSOR. 1492 00:52:19,600 --> 00:52:21,920 I WAS WONDERING, THERE ARE 1493 00:52:21,920 --> 00:52:23,760 SINGLE PAYOR SYSTEMS SUCH AS THE 1494 00:52:23,760 --> 00:52:28,040 VA, FOR EXAMPLE, THE DEPARTMENT 1495 00:52:28,040 --> 00:52:31,760 OF HEALTH, DOD, HEALTH SERVICES, 1496 00:52:31,760 --> 00:52:33,640 AND OTHER COUNTRIES, CANADA 1497 00:52:33,640 --> 00:52:38,560 COMES TO MIND WHERE M MEDICAL 1498 00:52:38,560 --> 00:52:40,840 CAROL IS COVERED BY THE STATE OR 1499 00:52:40,840 --> 00:52:43,040 IN THIS CASE VA OR SOME OTHER 1500 00:52:43,040 --> 00:52:45,320 RESOURCE BEYOND THE PATIENT. 1501 00:52:45,320 --> 00:52:49,600 DO YOU NOTICE IN TERMS OF CANCER 1502 00:52:49,600 --> 00:52:50,680 OUTCOMES, HAS THERE BEEN ANY 1503 00:52:50,680 --> 00:52:52,640 STUDIES TO LOOK AT THAT TO 1504 00:52:52,640 --> 00:52:53,640 DETERMINE IF YOU DO HAVE THESE 1505 00:52:53,640 --> 00:52:59,280 SORT OF MORE SINGLE PAYOR 1506 00:52:59,280 --> 00:53:00,680 MEDICAL SERVICES WITHOUT PATIENT 1507 00:53:00,680 --> 00:53:03,080 NEED TO CONTRIBUTE, IS THERE 1508 00:53:03,080 --> 00:53:06,120 EVIDENCE THAT THAT DOES IROVE 1509 00:53:06,120 --> 00:53:07,560 OUTCOME, CANCER OUTCOME, DO YOU 1510 00:53:07,560 --> 00:53:07,760 KNOW? 1511 00:53:07,760 --> 00:53:11,400 >> SO I'M NOT FAMILIAR WITH 1512 00:53:11,400 --> 00:53:12,360 STUDIES IN THE VA. 1513 00:53:12,360 --> 00:53:14,480 I SAW A PAPER THE OTHER DAY FOR 1514 00:53:14,480 --> 00:53:15,560 CANADA AND I HAVEN'T HAD A 1515 00:53:15,560 --> 00:53:17,920 CHANCE TO READ IT AS OF YET BUT 1516 00:53:17,920 --> 00:53:18,800 THERE WAS STILL SOME FINANCIAL 1517 00:53:18,800 --> 00:53:19,040 BURDEN. 1518 00:53:19,040 --> 00:53:21,480 IT MAY NOT BE TO THE EXTENT OF 1519 00:53:21,480 --> 00:53:24,000 WHAT WE SEE HERE GIVEN THAT THE 1520 00:53:24,000 --> 00:53:25,840 HEALTHCARE SYSTEM HAS -- IS 1521 00:53:25,840 --> 00:53:26,840 ORGANIZED THE WAY IT IS, BUT 1522 00:53:26,840 --> 00:53:27,720 SOME THINGS THAT I WOULD 1523 00:53:27,720 --> 00:53:29,880 CONSIDER, I THINK EVEN IN THOSE 1524 00:53:29,880 --> 00:53:33,400 SYSTEMS WHERE THERE IS COVERAGE, 1525 00:53:33,400 --> 00:53:34,600 THERE'S SO MANY OTHER COSTS 1526 00:53:34,600 --> 00:53:37,240 INDEPENDENT OF WHAT YOU PAY THE 1527 00:53:37,240 --> 00:53:38,320 HEALTHCARE SYSTEM FOR THAT CARE. 1528 00:53:38,320 --> 00:53:42,040 SO IF YOU HAVE TO DRIVE IN -- OR 1529 00:53:42,040 --> 00:53:43,560 EVEN IF YOU'RE FROM A RURAL 1530 00:53:43,560 --> 00:53:45,000 AREA, YOU'VE GOT TO DRIVE IN, 1531 00:53:45,000 --> 00:53:47,160 THOSE ARE COSTS, IF YOU HAVE A 1532 00:53:47,160 --> 00:53:48,280 SITUATION WHERE YOU HAVE TO STAY 1533 00:53:48,280 --> 00:53:50,000 FOR MULTIPLE DAY, ALL OF A 1534 00:53:50,000 --> 00:53:52,760 SUDDEN YOU'VE GOT A HOTEL COST 1535 00:53:52,760 --> 00:53:54,080 EVENTUALLY, IF YOU'RE TOO ILL TO 1536 00:53:54,080 --> 00:53:55,240 WORK, THEN YOU'VE LOST THAT 1537 00:53:55,240 --> 00:53:55,720 INCOME. 1538 00:53:55,720 --> 00:53:57,040 IF YOU'RE TOO ILL TO TAKE CARE 1539 00:53:57,040 --> 00:53:58,760 OF YOURSELF, THEN YOUR CAREGIVER 1540 00:53:58,760 --> 00:54:00,760 MAY HAVE TO REDUCE THEIR AMOUNT 1541 00:54:00,760 --> 00:54:02,280 OF TIME THAT THEY'RE WORKING. 1542 00:54:02,280 --> 00:54:04,040 SO THEY DON'T HAVE THAT INCOME. 1543 00:54:04,040 --> 00:54:08,880 SO I THINK EVEN OUTSIDE OF THE 1544 00:54:08,880 --> 00:54:10,480 DIRECT MEDICAL COSTS, THERE'S SO 1545 00:54:10,480 --> 00:54:12,320 MANY DOWNSTREAM THINGS THAT 1546 00:54:12,320 --> 00:54:15,800 COULD INCUR A COST FOR PATIENTS 1547 00:54:15,800 --> 00:54:18,040 AND FAMILIES THAT IT'S STILL 1548 00:54:18,040 --> 00:54:23,560 DIFFICULT AND CHALLENGING. 1549 00:54:23,560 --> 00:54:25,040 >> DAVID, DID YOU HAVE A 1550 00:54:25,040 --> 00:54:26,360 FOLLOW-UP TO THAT OR ANYTHING? 1551 00:54:26,360 --> 00:54:31,000 SO I DO HAVE ANOTHER QUESTION 1552 00:54:31,000 --> 00:54:34,040 FROM ONE OF OUR COLLEAGUES WHO'S 1553 00:54:34,040 --> 00:54:35,480 ASKING IF IT'S POSSIBLE FOR YOU 1554 00:54:35,480 --> 00:54:37,000 TO ELABORATE A LITTLE BIT ON 1555 00:54:37,000 --> 00:54:40,800 SORT OF THE BIDIRECTIONAL 1556 00:54:40,800 --> 00:54:41,800 INFLUENCES OF ECONOMIC 1557 00:54:41,800 --> 00:54:42,800 DISADVANTAGES AND MEDICAL 1558 00:54:42,800 --> 00:54:44,720 TREATMENT OUTCOMES, SORT OF 1559 00:54:44,720 --> 00:54:47,720 WHICH ASPECTS OF THE FINANCIAL 1560 00:54:47,720 --> 00:54:48,920 OR MEDICAL TREATMENT WOULD BE 1561 00:54:48,920 --> 00:54:52,680 MORE LIKELY TO CHANGE OUTCOME, 1562 00:54:52,680 --> 00:54:54,840 OR SHOULD YOU TRY TO TACKLE 1563 00:54:54,840 --> 00:54:58,920 THOSE THINGS AT THE SAME TIME? 1564 00:54:58,920 --> 00:55:00,120 DO YOU HAVE ANY THOUGHTS ON 1565 00:55:00,120 --> 00:55:01,640 THAT? 1566 00:55:01,640 --> 00:55:03,400 >> ? 1567 00:55:03,400 --> 00:55:05,040 >> I'M GOING TO READ IT IN CHAT 1568 00:55:05,040 --> 00:55:07,320 A LITTLE BIT TO MAKE SURE I 1569 00:55:07,320 --> 00:55:08,000 UNDERSTAND IT FULLY. 1570 00:55:08,000 --> 00:55:12,360 >> ABSOLUTELY. 1571 00:55:12,360 --> 00:55:15,560 >> YOU KNOW, I THINK WE DON'T 1572 00:55:15,560 --> 00:55:17,320 REALLY KNOW IF IT'S THE 1573 00:55:17,320 --> 00:55:19,040 FINANCIAL OR -- VERSUS MEDICAL 1574 00:55:19,040 --> 00:55:23,320 TREATMENT ASPECT. 1575 00:55:23,320 --> 00:55:27,360 YOU KNOW, I THINK WHAT'S TRICKY, 1576 00:55:27,360 --> 00:55:28,760 ESPECIALLY WHEN YOU THINK OF 1577 00:55:28,760 --> 00:55:30,320 ECONOMIC DISADVANTAGES, WE KNOW 1578 00:55:30,320 --> 00:55:31,280 THERE'S SO MANY OTHER THINGS 1579 00:55:31,280 --> 00:55:35,480 THAT THAT MEANS AS WELL, SO IT 1580 00:55:35,480 --> 00:55:36,920 MAY MEAN YOU DON'T HAVE ACCESS 1581 00:55:36,920 --> 00:55:38,560 TO HIGH QUALITY FOOD OR YOU'RE 1582 00:55:38,560 --> 00:55:41,720 MORE EXPOSED TO POLLUTION, SO IT 1583 00:55:41,720 --> 00:55:43,640 BECOMES REALLY TRICKY TO 1584 00:55:43,640 --> 00:55:48,200 DISENTANGLE ALL OF THOSE PIECES. 1585 00:55:48,200 --> 00:55:52,840 -- MOVE FORWARD TRYING TO DO IT 1586 00:55:52,840 --> 00:55:54,240 ALL. 1587 00:55:54,240 --> 00:55:56,440 I ALWAYS HAVE A DREAM AND A 1588 00:55:56,440 --> 00:55:56,760 VISION, SO -- 1589 00:55:56,760 --> 00:55:58,080 >> RIGHT. 1590 00:55:58,080 --> 00:55:58,520 NO, UNDERSTOOD. 1591 00:55:58,520 --> 00:56:00,160 I MEAN, THERE'S A LOT TO UNPACK 1592 00:56:00,160 --> 00:56:01,560 HERE AND AS YOU SAID, THERE'S A 1593 00:56:01,560 --> 00:56:05,400 LOT TO POTENTIALLY UNTANGLE. 1594 00:56:05,400 --> 00:56:06,280 DR. SHURTLEFF, DID YOU HAVE ANY 1595 00:56:06,280 --> 00:56:09,240 OTHER QUESTIONS? 1596 00:56:09,240 --> 00:56:10,760 WE DID HAVE ONE QUESTION THAT 1597 00:56:10,760 --> 00:56:11,760 CAME IN. 1598 00:56:11,760 --> 00:56:13,840 DO YOU THINK THERE'S BEEN ANY 1599 00:56:13,840 --> 00:56:17,320 IMPACT FROM COVID-19 IN THIS 1600 00:56:17,320 --> 00:56:19,960 SPACE, PARTICULARLY FOR CANCER 1601 00:56:19,960 --> 00:56:20,400 SURVIVORS? 1602 00:56:20,400 --> 00:56:22,920 HAS THERE BEEN ANYTHING THAT YOU 1603 00:56:22,920 --> 00:56:25,880 THINK HAS BEEN AN IMPACT FROM 1604 00:56:25,880 --> 00:56:26,120 COVID-19? 1605 00:56:26,120 --> 00:56:28,360 >> RIGHT. 1606 00:56:28,360 --> 00:56:29,920 SO I KNOW OF ONE PUBLISHED PAPER 1607 00:56:29,920 --> 00:56:34,960 THAT WAS NOT IN CANCER SURVIVORS 1608 00:56:34,960 --> 00:56:35,920 SPECIFICALLY, BUT IT DID SHOW 1609 00:56:35,920 --> 00:56:36,720 THAT THERE WAS AN ECONOMIC 1610 00:56:36,720 --> 00:56:39,000 BURDEN OF DISEASE FOR 1611 00:56:39,000 --> 00:56:43,400 INDIVIDUALS WHO HAD EXPERIENCED 1612 00:56:43,400 --> 00:56:45,440 COVID-19, INCLUDING USING ALL 1613 00:56:45,440 --> 00:56:48,440 FINANCIAL RESOURCES SHORTLY 1614 00:56:48,440 --> 00:56:49,000 AFTER DIAGNOSIS. 1615 00:56:49,000 --> 00:56:50,560 AND I'M HAPPY TO SHARE THAT 1616 00:56:50,560 --> 00:56:52,520 CITATION AS WELL. 1617 00:56:52,520 --> 00:56:53,400 >> THAT WOULD BE GREAT. 1618 00:56:53,400 --> 00:56:55,400 >> IT'S VERY IMPORTANT BECAUSE 1619 00:56:55,400 --> 00:56:57,200 TODAY WE'VE THOUGHT ABOUT 1620 00:56:57,200 --> 00:57:00,720 CHRONIC ILLNESS, AND I KNOW 1621 00:57:00,720 --> 00:57:02,200 COVID-19 HAS SOME INDIVIDUALS 1622 00:57:02,200 --> 00:57:04,200 WHO ARE DEALING WITH IT WELL 1623 00:57:04,200 --> 00:57:06,600 BEYOND, BUT WE THINK OF IT AS AN 1624 00:57:06,600 --> 00:57:07,800 ACUTE ILLNESS PRIMARILY AND 1625 00:57:07,800 --> 00:57:09,160 WE'RE SEEING THAT THERE'S 1626 00:57:09,160 --> 00:57:10,440 ECONOMIC BURDEN OF DISEASE 1627 00:57:10,440 --> 00:57:13,280 WITHOUT A DOUBT. 1628 00:57:13,280 --> 00:57:14,840 >> OKAY, GREAT. 1629 00:57:14,840 --> 00:57:16,520 WELL, DAVID, ANY FINAL COMMENTS 1630 00:57:16,520 --> 00:57:17,240 OR THOUGHTS? 1631 00:57:17,240 --> 00:57:19,320 >> I JUST WANT TO THANK YOU, DR. 1632 00:57:19,320 --> 00:57:19,840 THIS WAS GREAT. 1633 00:57:19,840 --> 00:57:20,880 YOU KNOW, I'M LOOKING FORWARD 1634 00:57:20,880 --> 00:57:24,680 TO, AS YOU POG THROUGH PRR 1635 00:57:24,680 --> 00:57:26,080 RESEARCH NETWORK ON EMOTIONAL 1636 00:57:26,080 --> 00:57:26,880 WELL-BEING, I'M INTERESTED IN 1637 00:57:26,880 --> 00:57:27,960 UPDATES AND HOW THIS IS GOING. 1638 00:57:27,960 --> 00:57:29,880 I THINK YOU'VE HIT ON AN 1639 00:57:29,880 --> 00:57:31,120 IMPORTANT PUBLIC HEALTH CONCERN, 1640 00:57:31,120 --> 00:57:33,440 TBRANGLY, WITH 1641 00:57:33,440 --> 00:57:35,600 FRANKLY, WITH MANY PEOPLE 1642 00:57:35,600 --> 00:57:38,640 STRUGGLING WITH HEALTHCARE COST 1643 00:57:38,640 --> 00:57:39,880 AND THAT WILL HELP US THINK 1644 00:57:39,880 --> 00:57:42,000 THROUGH HOW WE CAN DO BETTER BY 1645 00:57:42,000 --> 00:57:42,920 PATIENTS AS THEY GO THROUGH THIS 1646 00:57:42,920 --> 00:57:43,240 JOURNEY. 1647 00:57:43,240 --> 00:57:44,480 SO THANK YOU SO MUCH FOR YOUR 1648 00:57:44,480 --> 00:57:44,840 PRESENTATION. 1649 00:57:44,840 --> 00:57:48,640 IT WAS REALLY SORT OF 1650 00:57:48,640 --> 00:57:50,040 THOUGHT-PROVOKING IN MANY WAYS. 1651 00:57:50,040 --> 00:57:50,360 SO THANK YOU. 1652 00:57:50,360 --> 00:57:51,080 >> YOU'RE WELCOME. 1653 00:57:51,080 --> 00:57:53,200 THANK YOU FOR THE OPPORTUNITY TO 1654 00:57:53,200 --> 00:57:54,480 SHARE THIS AREA OF RESEARCH. 1655 00:57:54,480 --> 00:57:56,280 >> YES, AND THANK YOU SO MUCH, 1656 00:57:56,280 --> 00:57:57,280 DR. MARTIN, FOR JOINING US 1657 00:57:57,280 --> 00:58:00,880 TODAY, AND I THINK WE'RE GOING 1658 00:58:00,880 --> 00:58:01,840 TO CONCLUDE THE Q & A SESSION 1659 00:58:01,840 --> 00:58:04,720 NOW, AND SO I WANT TO THANK OUR 1660 00:58:04,720 --> 00:58:06,000 VIEWERS FOR JOINING US AND FOR 1661 00:58:06,000 --> 00:58:07,360 SHARING THEIR QUESTIONS AND A 1662 00:58:07,360 --> 00:58:08,200 REMINDER THAT THIS PRESENTATION 1663 00:58:08,200 --> 00:58:11,040 WAS INDEED RECORDED AND WILL BE 1664 00:58:11,040 --> 00:58:12,400 AVAILABLE FOR LATER VIEWING ON 1665 00:58:12,400 --> 00:58:17,080 THE NIH VIDEO VIDEOCAST WEBSE 1666 00:58:17,080 --> 00:58:18,480 PAST EVENTS SECTION. 1667 00:58:18,480 --> 00:58:20,120 AND DON'T FORGET TO JOIN US ON 1668 00:58:20,120 --> 00:58:20,440 JUNE 23RD. 1669 00:58:20,440 --> 00:58:22,280 WE'RE GOING TO BE HERE FROM NOON 1670 00:58:22,280 --> 00:58:23,760 TO 1:00 P.M. EASTERN FOR OUR 1671 00:58:23,760 --> 00:58:26,880 THIRD AND FINAL IMLS TALK FOR 1672 00:58:26,880 --> 00:58:28,320 THE SPRING, WHICH IS ALSO ON THE 1673 00:58:28,320 --> 00:58:29,520 THEME OF EMOTIONAL WELL-BEING 1674 00:58:29,520 --> 00:58:31,080 AND IT'S GOING TO BE ON 1675 00:58:31,080 --> 00:58:32,720 ADVANCING RESEARCH ON EMOTIONAL 1676 00:58:32,720 --> 00:58:33,600 WELL-BEING AND REGULATION OF 1677 00:58:33,600 --> 00:58:33,920 EATING. 1678 00:58:33,920 --> 00:58:35,720 THAT'S GOING TO BE PRESENTED BY 1679 00:58:35,720 --> 00:58:36,920 DR. ALYSSA POWELL OF THE 1680 00:58:36,920 --> 00:58:37,520 UNIVERSITY OF CALIFORNIA AT 1681 00:58:37,520 --> 00:58:39,760 SAN FRANCISCO. 1682 00:58:39,760 --> 00:58:40,800 AND WITH THAT, THANK YOU SO 1683 00:58:40,800 --> 00:58:42,000 MUCH, DR. MARTIN. 1684 00:58:42,000 --> 00:58:44,120 WE ENJOYED HAVING YOU WITH US 1685 00:58:44,120 --> 00:58:45,440 TODAY, ENJOYED YOUR PRESENTATION 1686 00:58:45,440 --> 00:58:46,360 VERY MUCH, AND WE LOOK FORWARD 1687 00:58:46,360 --> 00:58:48,480 TO WORKING WITH YOU IN THE 1688 00:58:48,480 --> 00:58:49,800 FUTURE AND AS YOUR RESEARCH 1689 00:58:49,800 --> 00:58:50,120 PROGRESSES. 1690 00:58:50,120 --> 00:58:52,960 SO HAVE A WONDERFUL DAY, 1691 00:58:52,960 --> 00:58:53,680 EVERYBODY. 1692 00:58:53,680 --> 00:59:03,840 BYE-BYE.